Peripheral Nerve Stimulation for Chronic Foot Pain Induced by Morton Neuroma: A Novel, Personalized Approach in One Patient.

Neurosurgery practice Pub Date : 2023-06-12 eCollection Date: 2023-09-01 DOI:10.1227/neuprac.0000000000000043
Brian Fabian Saway, Reese Townsend Terry, Aimee C Weber, Nathan C Rowland
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Abstract

Background and importance: Morton neuroma (MN) is a condition characterized by pain that is located within one or more intermetatarsal spaces of the forefoot. Numerous conservative measures are available for the management of mild-to-moderate MN cases. In more severe presentations, surgical interventions may be considered, including neuroma excision, cryogenic or radiofrequency ablation, and decompression. However, no standard treatments exist for occurrences of recurrent MN after surgery. Peripheral nerve stimulation is a neuromodulatory treatment that is highly effective for other neuropathic pain syndromes but remains underutilized for MN.

Clinical presentation: Here, we present the operative technique and clinical outcome in a patient with chronic pain induced by MN who underwent bilateral implantation of peripheral nerve stimulation devices. In less than 12 months, the patient had near-complete resolution of chronic foot pain with no postoperative complications.

Discussion: We present the first published case and operative technique of successful peripheral nerve stimulator implantation as an effective treatment of MN.

Conclusion: Peripheral nerve stimulator implantation is a promising and effective intervention that can be considered for refractory MN.

外周神经刺激治疗莫顿神经瘤引起的慢性足痛:一种新颖的个性化治疗方法。
背景和重要性:莫顿神经瘤(MN)是一种以前脚一个或多个跖骨间隙疼痛为特征的疾病。许多保守措施可用于管理轻至中度MN病例。在更严重的情况下,可以考虑手术干预,包括神经瘤切除、低温或射频消融和减压。然而,对于手术后复发性MN的发生尚无标准的治疗方法。周围神经刺激是一种神经调节治疗,对其他神经性疼痛综合征非常有效,但对MN的应用仍不足。临床表现:在这里,我们报告了一例MN引起的慢性疼痛患者接受双侧周围神经刺激装置植入的手术技术和临床结果。在不到12个月的时间里,患者几乎完全解决了慢性足部疼痛,没有术后并发症。讨论:我们提出了第一个成功的周围神经刺激器植入作为MN有效治疗的病例和手术技术。结论:周围神经刺激器植入术是治疗难治性脑脊炎的有效方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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