Radiofrequency Thermo-Ablation of Morton’s Neuroma: A Valid Minimally Invasive Treatment Procedure in Patients Resistant to Conservative Treatment

Abstract

Background: The authors present the personal results of the review of a group of cases treated for Morton's neuroma with continuous radiofrequency (CRF) thermo-ablation of the plantar intermetatarsal nerve. Methods: This retrospec-tive review consisted of 29 patients treated between January 2008 and December 2011, with a minimum 1 year follow-up. Three patients underwent bilateral treatment and 10 patients underwent concomitant treatment procedures for asso-ciated foot disorders: hallux valgus (7), tailor's bunion (2) and hammertoe (5). The procedure was performed in a day hospital setting under direct fluoroscopic control. Results: The follow-up protocol used a visual analog scale (VAS) for pain (0 = no pain, 10 = worst pain) and a visual analog scale (VAS) for patient satisfaction (0 = no satisfaction, 10 = complete satisfaction). Success was defined by a decrease of 5 points in pain at 1 year after the treatment procedure. From these 29 cases, with a VAS pain score between severe and worst pain ever, treatment with CRF thermo-ablation at one year follow-up yielded these results: 14 cases with no pain (48%), 7 cases with mild pain (24%), 5 cases with mod-erate pain (17%), 3 cases still with severe pain (10%). The overall benefit was that 88% of the patients had significant pain improvements. From another point of view, 26 cases (89.6%) had a decrease of the VAS score between 5 and 10 points and in only 3 cases (10.3%) severe pain was reported, even though it was slightly diminished after the procedure. Conclusion: Continuous radiofrequency (CRF) thermo-ablation of Morton's neuroma (Entrapment) was a safe and minimally invasive surgical procedure which gave these patients great satisfactions and a rapid return to normal activity.