Percutaneous alcohol injection under sonographic guidance in Morton’s neuroma: follow-up in 220 treated lesions

Abstract

Ultrasound-guided alcoholization demonstrated a safe profile, relieved neuropathic symptoms in a majority of patients and improved their quality of life. Rescue therapy with surgery is feasible in patients with unsatisfactory response. However, a thorough evaluation for forefoot comorbidities should be obtained, as they may act as confounding factors.

Injection Techniques for Common Chronic Pain Conditions of the Foot: A Comprehensive Review

“…However, the beneficial effects diminished over a short period of time [10]. In addition to the short-term effects, Perini et al also noted diminished short-term pain after injection in 73% of their patients (P \ 0.001) [11]. However, there were side effects that resulted in pain in the injection site, skin lesions, tissue alterations consist with ''steroid flare,'' tissue atrophy, and pigment alterations [9,11].…”

“…Alcohol injections are another method to treat MN instead of corticosteroid injections. Alcohol is usually mixed with a local anesthetic and guided via ultrasound into the neuroma [11]. The concentration of alcohol that is injected for MN varies, although the beneficial results are amplified as the concentration of alcohol increases [9].…”

“…There is local transient pain at the site of injection as the concentration of alcohol is increased from 30 to 50%, but it is short lived [9]. More research needs to be conducted on alcohol-based treatments and this therapy should only be used if more evidence-based treatments fail to produce beneficial results [9,11].…”

Percutaneous Image-Guided Treatment of Benign Musculoskeletal Tumors in Children

“…57 Percutaneous alcohol ablation has demonstrated an 80% reduction in patients progressing to resection 57 and successful treatment in 60 to 94% of cases. 65 RFA had a success rate > 85% in one study 66 and a 70% reduction in patients progressing to surgery in another. 67 Surgical resection has a success rate approaching 85%, with 62 to 65% having complete relief by final followup 57,66 and a failure rate of 14 to 21%.…”

Ultrasound-Guided Treatment of Peripheral Nerve Pathology

“…Options for ablative therapy include cryotherapy, pulsed or continuous radiofrequency ablation (RFA), microwave therapy, or ethanol injection. [13][14][15] The pain and complications associated with cryotherapy are thought to be less common than with the other treatment modalities due to the ability to better control the ice ball during the treatment. 16 Smaller needles (22G) are available for RFA as compared with cryoablation (17G).…”