title: Effects of alcohol injection in rat sciatic nerve as a model for Morton's neuroma treatment.
abstract: BACKGROUND
  Previous studies have shown that the injection of dehydrated alcohol has been successful for the treatment of Morton's neuroma in the foot. In this study, we determined the cellular effect of injection of alcohol into and around the sciatic nerve of rats and measured the extent of cell necrosis and/or any associated histologic or inflammatory changes.
  
  
  METHODS
  Twenty-two male (~375 g) Wistar rats were randomized into 2 groups each receiving alcohol injections into or around the sciatic nerve after nerve exposure under sterile technique. Group 1 rats were injected with a 0.5 ml solution of 0.5% Marcaine in the left sciatic nerve as a control group. In the right sciatic nerve a 0.5 ml solution of 4% ethanol with 0.5% Marcaine was injected. Group 2 rats received 0.5 ml of 20% ethanol with 0.5% Marcaine injected into the left sciatic nerve and 0.5 ml of 30% ethanol with 0.5% Marcaine injected into the right sciatic nerve. In each group, the rats were placed in 3 subgroups: intraneural, perineural, perimuscular injections. All rats were sacrificed and tissue harvested for histologic evaluation at day 10 post injection.
  
  
  RESULTS
  No evidence of alcohol-associated cell necrosis, apoptosis, or apparent inflammation was observed in histologic specimens of any injected nerves, perineural tissue, or muscles in controls or experimental groups regardless of concentration of ethanol injected on day 10.
  
  
  CONCLUSIONS
  We concluded that alcohol injection (≤30% ethanol) into and/or around the sciatic nerve or the adjacent muscle of rats has no histologic evidence of necrosis or inflammation to the nerve or surrounding tissue. There was no observable histological change in apoptosis, or cell number, in response to the alcohol injection.
  
  
  CONCLUSIONS
  The lack of any measureable changes in nerve or adjacent muscle histology with ethanol injection into the rat sciatic nerve (and surrounding tissues) raises questions about the efficacy of using ethanol injections in the treatment of Morton's neuroma in human clinical practice.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA MJMazoch@uams.edu.
authors.forename: Mathew J
authors.initials: MJ
authors.lastname: Mazoch
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Gulraiz A
authors.initials: GA
authors.lastname: Cheema
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Suva
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Thomas
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D000431:Ethanol / Q000008:administration & dosage*; D005534:Foot Diseases / Q000188:drug therapy; D020287:In Situ Nick-End Labeling; D007267:Injections; D008297:Male; D009463:Neuroma / Q000188:drug therapy; D010524:Peripheral Nervous System Neoplasms / Q000188:drug therapy; D010865:Pilot Projects; D051381:Rats; D017208:Rats, Wistar; D012584:Sciatic Nerve / Q000187:drug effects*
chemical_list: D000431:Ethanol
keywords: Morton’s neuroma; alcohol; ethanol; foot; interdigital neuroma; sclerosing therapy
references.citation: J Am Acad Orthop Surg. 2008 Sep;16(9):550-7
references.pmid: 18768712
references.citation: Gastrointest Endosc. 1991 Jul-Aug;37(4):460-4
references.pmid: 1916169
references.citation: AJR Am J Roentgenol. 2007 Jun;188(6):1535-9
references.pmid: 17515373
references.citation: Foot Ankle Int. 2013 Aug;34(8):1064-7
references.pmid: 23669161
references.citation: J Fam Pract. 2011 Mar;60(3):157-8, 168
references.pmid: 21369560
references.citation: Foot Ankle Int. 2004 Feb;25(2):79-84
references.pmid: 14992707
references.citation: Neurosurgery. 1983 Dec;13(6):681-8
references.pmid: 6318149
references.citation: Eur Radiol. 2004 Mar;14(3):514-8
references.pmid: 14531002
references.citation: J Bone Joint Surg Am. 2013 May 1;95(9):790-8, S1
references.pmid: 23636185
references.citation: J Diabetes Res. 2013;2013:149452
references.pmid: 23984428
references.citation: J Am Podiatr Med Assoc. 2007 May-Jun;97(3):203-6
references.pmid: 17507528
references.citation: J Foot Ankle Surg. 2005 Jul-Aug;44(4):287-91
references.pmid: 16012436
references.citation: Br J Surg. 1989 Mar;76(3):254-5
references.pmid: 2720320
references.citation: Foot Ankle Int. 2011 Jun;32(6):576-80
references.pmid: 21733418
references.citation: J Foot Ankle Surg. 1999 Nov-Dec;38(6):403-8
references.pmid: 10614611
references.citation: Foot Ankle Int. 1995 Dec;16(12):760-3
references.pmid: 8749346
references.citation: Pain. 2008 May;136(1-2):188-201
references.pmid: 18316160
references.citation: Minerva Ginecol. 2006 Jun;58(3):245-8
references.pmid: 16783297
references.citation: AJR Am J Roentgenol. 1996 Sep;167(3):781-3
references.pmid: 8751700