Ultrasound-Guided Percutaneous Radiofrequency for the Treatment of Morton's Neuroma.

Abstract

Morton's neuroma (MN) is a leading cause of disability. The purpose of this study was to investigate the effectiveness of radiofrequency (RF) in patients with chronic pain refractory to conservative therapies. Between September 2012 and December 2016, RF was performed on 52 patients. A sterile RF needle probe (22G, 5-cm needle with 10-mm electrode active tip) was inserted between the toes into the intermetatarsal space at the center of the lesion. Potential complications of the intervention and post-procedure care were examined. All patients provided written, informed consent. All percutaneous procedures were performed with the NeuroTherm® NT1100 (Neurotherm Inc., M.) device and using ultrasound guidance (Philips IU22). Continuous RF was performed with one cycle of 90s and with the probe tip maintaining a temperature of 85°C (impedance 95-210mΩ). Mean VAS score before the procedures was 9.0±0.6. A reduction of pain intensity was achieved after 1week by RF (mean VAS scores 3.7±0.9; p<0.05), with a stabilization of the painful symptomatology in the following months and after 1year of treatments (mean VAS scores 2.0±0.4 after 12months, p<0.05). The FHSQ scores showed improved quality of life (QOL) in all patients at 6months (p<0.05) and 1year (p<0.05) of RF. No patients developed complications. RF is a safe, efficient, and minimally invasive technique for the treatment of symptomatic MN.