背景:莫顿神经瘤(MN)是足部最常见的神经系统病变之一,影响了大约4%的普通人群。MN的治疗可以是手术,保守,渗透,MN注射中使用的不同物质,作为类固醇,硬化溶液,和其他人。这篇综述旨在评估目前对Morton神经瘤的浸润性治疗的疗效,此外,定义这种疗法的不良反应。
方法:在PubMed,Embase,CINHAL,认识论,WebofScience(WOS),SPORTSDiscusandCochraneLibrary.此搜索涉及适用于MN的所有类型的渗透治疗的应用。搜索仅限于使用视觉模拟疼痛量表(VAS)或Johnson满意度量表描述临床结果和疼痛的原始数据,2023年2月至6月。
结果:选择了12份手稿(6项随机对照试验和6项纵向观察研究),涉及1,438例患者。据报道辣椒素产生51.8%的VAS评分降低。皮质类固醇还报告了高水平的疗效。酒精和透明质酸注射耐受性良好,但其应用效果有待进一步研究。无严重不良事件发生。
结论:皮质类固醇,硬化剂注射,透明质酸和辣椒素已被证明可有效减轻与MN相关的疼痛。
BACKGROUND: Morton\'s neuroma (MN) is one of the most frequent neurological pathologies in feet, affecting approximately 4% of the general population. The treatment of MN can be surgical, conservative, and infiltrative, with different substances used in the injections for MN, as steroids, sclerosing solutions, and others. This review aims to evaluate the efficacy of current infiltrative therapy for Morton\'s neuroma and, additionally, to define adverse effects of this therapy.
METHODS: A literature search was performed in PubMed, Embase, CINHAL, Epistemonikos, Web of Science (WOS), SPORTSDiscus and Cochrane Library. This search involved the application of all types of infiltrative treatment applicable to MN. The search was limited to original data describing clinical outcomes and pain using the Visual Analogue pain Scale (VAS) or the Johnson Satisfaction Scale, between February and June 2023.
RESULTS: Twelve manuscripts were selected (six randomized controlled trials and six longitudinal observational studies) involving 1,438 patients. Capsaicin was reported to produce a VAS score reduction of 51.8%. Corticosteroids also reported a high level of efficacy. Alcohol and Hyaluronic Acid injections are well tolerated, but the effects of their application need further research. There were no serious adverse events.
CONCLUSIONS: Corticosteroids, sclerosant injections, hyaluronic acid and capsaicin have been shown to be effective in reducing the pain related to MN.