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Ultrasound-Guided Continuous Radiofrequency Ablation Of Painful Residual Limb Neuroma In Individuals With Limb Amputation-A Retrospective Case Series
BACKGROUND: Residual limb neuromas are a significant cause of post-amputation pain. There is little knowledge concerning ultrasound-guided (US) radiofrequency ablation (RFA) as treatment. OBJECTIVE: To investigate US-guided RFA for neuroma associated pain in individuals with limb amputation. METHODO...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Canadian Online Publication Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443475/ https://www.ncbi.nlm.nih.gov/pubmed/37614805 http://dx.doi.org/10.33137/cpoj.v2i1.33061 |
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author | Guo, S. Mansour, R. Henderson Slater, D. |
author_facet | Guo, S. Mansour, R. Henderson Slater, D. |
author_sort | Guo, S. |
collection | PubMed |
description | BACKGROUND: Residual limb neuromas are a significant cause of post-amputation pain. There is little knowledge concerning ultrasound-guided (US) radiofrequency ablation (RFA) as treatment. OBJECTIVE: To investigate US-guided RFA for neuroma associated pain in individuals with limb amputation. METHODOLOGY: The notes of nine consecutive patients were retrospectively reviewed. Information obtained included neuroma size and nerve, RFA duration/temperature, pain scores, analgesic requirements and ease/comfort of prosthetic use. Eight patients had lower-limb amputations and one had a trans-radial amputation. All except one, underwent diagnostic US-guided steroid injection to confirm the neuroma as the source of pain, prior to RFA. RESULTS: Six patients reported significant reduction in pain scores (defined as at least 50% reduction) and an improvement in comfort/ease of wearing their prosthetic limb, with no adverse effects. Three of these six patients also reported a reduction in analgesic requirements. Of the three remaining patients – one had a large sciatic nerve neuroma that was eventually surgically excised, another had confounding pain from an adjacent bony spur, whilst the third patient did not receive a routine diagnostic steroid injection prior to RFA. CONCLUSIONS: Our findings suggest that US-guided RFA is safe and effective for small to medium-sized residual limb neuroma associated pain in individuals with limb amputation. It can reduce pain and analgesic requirements, improve comfort/ease of wearing the prosthesis and potentially avoid surgical excision. We recommend patients should undergo a diagnostic steroid injection prior to RFA to confirm that the neuroma is the source of pain. |
format | Online Article Text |
id | pubmed-10443475 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Canadian Online Publication Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-104434752023-08-23 Ultrasound-Guided Continuous Radiofrequency Ablation Of Painful Residual Limb Neuroma In Individuals With Limb Amputation-A Retrospective Case Series Guo, S. Mansour, R. Henderson Slater, D. Can Prosthet Orthot J Case Series BACKGROUND: Residual limb neuromas are a significant cause of post-amputation pain. There is little knowledge concerning ultrasound-guided (US) radiofrequency ablation (RFA) as treatment. OBJECTIVE: To investigate US-guided RFA for neuroma associated pain in individuals with limb amputation. METHODOLOGY: The notes of nine consecutive patients were retrospectively reviewed. Information obtained included neuroma size and nerve, RFA duration/temperature, pain scores, analgesic requirements and ease/comfort of prosthetic use. Eight patients had lower-limb amputations and one had a trans-radial amputation. All except one, underwent diagnostic US-guided steroid injection to confirm the neuroma as the source of pain, prior to RFA. RESULTS: Six patients reported significant reduction in pain scores (defined as at least 50% reduction) and an improvement in comfort/ease of wearing their prosthetic limb, with no adverse effects. Three of these six patients also reported a reduction in analgesic requirements. Of the three remaining patients – one had a large sciatic nerve neuroma that was eventually surgically excised, another had confounding pain from an adjacent bony spur, whilst the third patient did not receive a routine diagnostic steroid injection prior to RFA. CONCLUSIONS: Our findings suggest that US-guided RFA is safe and effective for small to medium-sized residual limb neuroma associated pain in individuals with limb amputation. It can reduce pain and analgesic requirements, improve comfort/ease of wearing the prosthesis and potentially avoid surgical excision. We recommend patients should undergo a diagnostic steroid injection prior to RFA to confirm that the neuroma is the source of pain. Canadian Online Publication Group 2019-11-03 /pmc/articles/PMC10443475/ /pubmed/37614805 http://dx.doi.org/10.33137/cpoj.v2i1.33061 Text en Copyright (c) 2019 Shigong Guo, Ramy Mansour, David Henderson Slater https://creativecommons.org/licenses/by/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Case Series Guo, S. Mansour, R. Henderson Slater, D. Ultrasound-Guided Continuous Radiofrequency Ablation Of Painful Residual Limb Neuroma In Individuals With Limb Amputation-A Retrospective Case Series |
title | Ultrasound-Guided Continuous Radiofrequency Ablation Of Painful Residual Limb Neuroma In Individuals With Limb Amputation-A Retrospective Case Series |
title_full | Ultrasound-Guided Continuous Radiofrequency Ablation Of Painful Residual Limb Neuroma In Individuals With Limb Amputation-A Retrospective Case Series |
title_fullStr | Ultrasound-Guided Continuous Radiofrequency Ablation Of Painful Residual Limb Neuroma In Individuals With Limb Amputation-A Retrospective Case Series |
title_full_unstemmed | Ultrasound-Guided Continuous Radiofrequency Ablation Of Painful Residual Limb Neuroma In Individuals With Limb Amputation-A Retrospective Case Series |
title_short | Ultrasound-Guided Continuous Radiofrequency Ablation Of Painful Residual Limb Neuroma In Individuals With Limb Amputation-A Retrospective Case Series |
title_sort | ultrasound-guided continuous radiofrequency ablation of painful residual limb neuroma in individuals with limb amputation-a retrospective case series |
topic | Case Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10443475/ https://www.ncbi.nlm.nih.gov/pubmed/37614805 http://dx.doi.org/10.33137/cpoj.v2i1.33061 |
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