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. 2024 Jun;47(6):795-800.
doi: 10.1007/s00270-024-03669-1. Epub 2024 Mar 4.

Safety and Efficacy of Percutaneous Morton Neuroma Cryoneurolysis Under Ultrasound Guidance

Benjamin Moulin  1 , Giorgio Angelopoulos  2 , Jean Luc Sarrazin  2 , Stephane Romano  2 , Olivier Vignaux  2 , Thierry Guenoun  2 , Massimiliano Di Primio  2 , Antoine Hakime  2
Affiliations

Safety and Efficacy of Percutaneous Morton Neuroma Cryoneurolysis Under Ultrasound Guidance

Benjamin Moulin et al. Cardiovasc Intervent Radiol. 2024 Jun.

Abstract

Purpose: To assess the technical success, safety and early efficacy of Morton neuroma (MN) cryoneurolysis.

Materials and methods: Retrospective review of 54 consecutive patients with MN treated with cryoneurolysis after failure of conservative treatment, from September 2022 to June 2023. Outcomes measurements included technical success (defined a successful ultrasound-guided placement of the cryoprobe), procedural safety according to Cirse classification and change in 6 months post-procedure by pain numeric rating scale (pNRS).

Results: A total of 59 MN were treated during 55 procedures. Mean procedure duration was 47 min, all patients were discharged 2 h after the intervention. Technical success was 98.1%. No Cirse grade 3, 4 or 5 complication was reported. Three grade 2 complication occurred, including two chilblain-type lesions and one bone insufficiency fracture. At 6 months post-procedure, pNRS score was significantly decreased (2.7 ± 2.2 vs 7.1 ± 1.1) (p < 0.0001), with a mean score decrease of 4.1points. Thirty-two patients (60.4%) reported a complete pain relief, 15 (28.3%) a partial pain relief and 6 (11.3%) no pain relief, or increased pain.

Conclusion: Cryoneurolysis seems to be safe for the treatment of Morton neuroma. Six-month pain relief is promising and needs to be confirmed at long term.

Keywords: Cryoneurolysis; Metatarsalgia; Morton neuroma; Ultrasound guidance.

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