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Practical Experience with Sonographically Guided Phenol Instillation of Stump Neuroma: Predictors of Effects, Success, and Outcome

Hannes Gruber1, Bernhard Glodny1, Gerd Bodner2, Helmut Kopf3, Nadine Bendix1, Klaus Galiano4, Alexander Strasak5 and Siegfried Peer1

1 Department of Radiology, Radiodiagnostics Clinic, Department I, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
2 Department of Radiology, St. Bernard's Hospital, Gibraltar.
3 Zentralroentgeninstitut, Wilhelminenspital Wien, Vienna, Austria.
4 Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria.
5 Department of Medical Statistics, Computer Sciences, and Health Management, Medical University of Innsbruck, Innsbruck, Austria.


Figure 1
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  		Fig. 1 —73-year-old man with stump neuroma of right tibial nerve after traumatic amputation 30 years ago. Sonographic image shows phenol instillation into neck (arrowheads) of stump neuroma (asterisk). Tip (long arrow) of needle (short arrows) is positioned intraneurally with fusiform widening of targeted nerve segment caused by injected phenol. Surrounding hypoechoic patchy fluid accumulations are caused by local anesthetic.

 

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  		Fig. 2 —Graph shows general changes in pain quantity (median visual analog scale score) during treatment of all patients according to pain quality.

 

Figure 3
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  		Fig. 3 —Graph shows changes in pain quantity (median visual analog scale score) during treatment of patients available for 6-month follow-up assessment (n = 52).

 

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