Subscribe to RSS
DOI: 10.1055/a-2737-7207
Peripheral Nerve Ultrasound-guided Intervention: From the Basics to Sonosurgery
Authors
Abstract
Ultrasound-guided intervention of peripheral nerves is a new and promising branch of sonography. It offers minimally invasive therapeutic solutions with relatively little effort and has thus become an alternative to surgical procedures for managing entrapment neuropathies. It has shown considerable success in treating carpal tunnel syndrome, as well as other neuropathies caused by compression or focal strangulations. Sonosurgery, in particular, has become established as a validated reliable alternative to both open and endoscopic surgery. This review article critically examines the historical development of peripheral nerve ultrasound-guided intervention, leading ultimately to sonosurgery, and describes potential future uses.
Publication History
Received: 16 October 2025
Accepted: 30 October 2025
Article published online:
20 February 2026
© 2026. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Gruber H, Loizides A, Moriggl B. eds. Sonographic Peripheral Nerve Topography: A Landmark-based Algorithm. Berlin, Germany: Springer; 2019
- 2 Le Corroller T. High-resolution ultrasound of peripheral nerve disorders. Semin Musculoskelet Radiol 2024; 28 (06) 708-717
- 3 Adler RS. What is the place of ultrasound in MSK imaging?. Skeletal Radiol 2024; 53 (09) 1699-1709
- 4 Narouze SN. Ultrasound-guided interventional procedures in pain management: Evidence-based medicine. Reg Anesth Pain Med 2010; 35 (2, Suppl): S55-S58
- 5 Symanski JS, Ross AB, Davis KW, Brunner MC, Lee KS. US for traumatic nerve injury, entrapment neuropathy, and imaging-guided perineural injection. Radiographics 2022; 42 (05) 1546-1561
- 6 Peng PW, Narouze S. Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy, and procedures: part I: nonaxial structures. Reg Anesth Pain Med 2009; 34 (05) 458-474
- 7 Narouze S, Peng PW. Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy, and procedures. Part II: axial structures. Reg Anesth Pain Med 2010; 35 (04) 386-396
- 8 Chang KV, Wu WT, Özçakar L. Ultrasound imaging and guidance in peripheral nerve entrapment: hydrodissection highlighted. Pain Manag (Lond) 2020; 10 (02) 97-106
- 9 Lam KHS, Hung CY, Chiang YP. et al. Ultrasound-guided nerve hydrodissection for pain management: rationale, methods, current literature, and theoretical mechanisms. J Pain Res 2020; 13: 1957-1968
- 10 Honold S, Honis HR, Gruber H, Konschake M, Moriggl B, Loizides A. Imaging of anatomical variants of the lower limb nerves: clinical and preoperative relevance. Semin Musculoskelet Radiol 2023; 27 (02) 136-152
- 11 Honis HR, Gruber H, Honold S. et al. Anatomical considerations of US-guided carpal tunnel release in daily clinical practice. J Ultrason 2023; 23 (94) e131-e143
- 12 Petrover D, Hakime A, Silvera J, Richette P, Nizard R. Ultrasound-guided surgery for carpal tunnel syndrome: a new interventional procedure. Semin Intervent Radiol 2018; 35 (04) 248-254
- 13 Nakamichi K. [Ultrasonography for carpal tunnel syndrome]. Brain Nerve 2014; 66 (03) 209-221
- 14 Loizides A, Honold S, Skalla-Oberherber E. et al. Ultrasound-guided minimal invasive carpal tunnel release: an optimized algorithm. Cardiovasc Intervent Radiol 2021; 44 (06) 976-981
- 15 Honold S, Loizides A, Skalla E, Gruber L, Plaikner M, Gruber H. Minimally invasive ultrasound-guided carpal tunnel release: long-term clinical outcomes. Ultraschall Med 2025 September 8 (Epub ahead of print)
- 16 Kumar N, Chandan SK, Jalan D, Sinha S, Jaiswal B, Singh DK. Ultrasound-guided interventions in primary carpal tunnel syndrome: perineural injection to thread carpal tunnel release. Br J Radiol 2023; 96 (1150): 20230552
- 17 Ricardo Nunes C, Marès O, Martinel V. Ultrasound-guided release of carpal tunnel syndrome—anterograde technique. Hand Surg Rehabil 2025; 44S: 102091
- 18 Buncke G, McCormack B, Bodor M. Ultrasound-guided carpal tunnel release using the manos CTR system. Microsurgery 2013; 33 (05) 362-366
- 19 Omejec G, Podnar S. What causes ulnar neuropathy at the elbow?. Clin Neurophysiol 2016; 127 (01) 919-924
- 20 Poujade T, Hanouz N, Lecoq B, Hulet C, Collon S. Ultrasound-guided surgical treatment for ulnar nerve entrapment: a cadaver study. Chir Main 2014; 33 (04) 256-262
- 21 Guo D, Kliot M, McCool L, Senk A, Tonkin B, Guo D. Percutaneous cubital tunnel release with a dissection thread: a cadaveric study. J Hand Surg Eur Vol 2019; 44 (09) 920-924
- 22 Gruber H, Honold S, Skalla E, Konschake M, Loizides A. Novel minimally invasive ultrasound-guided cubital tunnel release: extending the scope?. Ultraschall Med 2022; 43 (04) 403-405
- 23 Luz J, Johnson AH, Kohler MJ. Point-of-care ultrasonography in the diagnosis and management of superficial peroneal nerve entrapment: case series. Foot Ankle Int 2014; 35 (12) 1362-1366
- 24 Margulis M, Ben Zvi L, Bernfeld B. Bilateral common peroneal nerve entrapment after excessive weight loss: case report and review of the literature. J Foot Ankle Surg 2018; 57 (03) 632-634
- 25 Fortier LM, Markel M, Thomas BG, Sherman WF, Thomas BH, Kaye AD. An update on peroneal nerve entrapment and neuropathy. Orthop Rev (Pavia) 2021; 13 (02) 24937
- 26 Guo D, Guo D, Harrison R. et al. A cadaveric study using the ultra-minimally invasive thread transection technique to decompress the superficial peroneal nerve in the lower leg. Acta Neurochir (Wien) 2019; 161 (10) 2133-2139
- 27 Moroni S, Zwierzina M, Starke V, Moriggl B, Montesi F, Konschake M. Clinical-anatomic mapping of the tarsal tunnel with regard to Baxter's neuropathy in recalcitrant heel pain syndrome: part I. Surg Radiol Anat 2019; 41 (01) 29-41
- 28 Fernández-Gibello A, Moroni S, Camuñas G. et al. Ultrasound-guided decompression surgery of the tarsal tunnel: a novel technique for the proximal tarsal tunnel syndrome-Part II. Surg Radiol Anat 2019; 41 (01) 43-51
- 29 Moroni S, Gibello AF, Zwierzina M. et al. Ultrasound-guided decompression surgery of the distal tarsal tunnel: a novel technique for the distal tarsal tunnel syndrome-part III. Surg Radiol Anat 2019; 41 (03) 313-321
- 30 Iborra A, Villanueva M, Sanz-Ruiz P. Results of ultrasound-guided release of tarsal tunnel syndrome: a review of 81 cases with a minimum follow-up of 18 months. J Orthop Surg Res 2020; 15 (01) 30
- 31 Mak MS, Chowdhury R, Johnson R. Morton's neuroma: review of anatomy, pathomechanism, and imaging. Clin Radiol 2021; 76 (03) 235.e15-235.e23
- 32 Lee W, McDonald J, Azam M, Lachance AD. The comparison of postoperative outcomes in Morton's neuroma excision between plantar versus dorsal approach: A systematic review and meta-analysis. Foot Ankle Surg 2024; 30 (08) 621-629
- 33 Zhang J, Li J, Cai W. et al. Effect of surgical approach on the treatment of Morton's neuroma: a systematic review and meta-analysis. J Foot Ankle Res 2023; 16 (01) 57
- 34 Saur M, Bejarano-Pineda L, Ollivier I, Koch G, Clavert P. Intermetatarsal ligament section assisted with sonography for the percutaneous surgery of Morton's disease: cadaveric study. Foot Ankle Surg 2022; 28 (07) 1106-1109
- 35 Nieves GC, Fernández-Gibello A, Moroni S. et al. Anatomic basis for a new ultrasound-guided, mini-invasive technique for release of the deep transverse metatarsal ligament. Clin Anat 2021; 34 (05) 678-684
- 36 Iborra-Marcos A, Villanueva-Martinez M, Barrett SL, Sanz-Ruiz P. Ultrasound-guided decompression of the intermetatarsal nerve for Morton's neuroma: a novel closed surgical technique. J Am Podiatr Med Assoc 2020; 110 (06) 8
