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. 2023 Nov 1;102(11):1008-1013.
doi: 10.1097/PHM.0000000000002267. Epub 2023 Apr 24.

Analysis of Adverse Effects of Cryoneurolysis for the Treatment of Spasticity

Paul Winston  1 , Fraser MacRae, Shanika Rajapakshe, Isabella Morrissey, Ève Boissonnault, Daniel Vincent, Mahdis Hashemi
Affiliations

Analysis of Adverse Effects of Cryoneurolysis for the Treatment of Spasticity

Paul Winston et al. Am J Phys Med Rehabil. .

Abstract

Objective: The aim of the study is to report adverse effects from clinical studies on ultrasound-guided percutaneous cryoneurolysis for spasticity.

Design: Patients were prospectively enrolled in three studies at a single institution. Cryoneurolysis was performed to primarily motor nerve branches (medial and lateral pectoral, musculocutaneous, radial, median, ulnar, tibial, obturator) and mixed motor sensory nerve trunks (median, ulnar, suprascapular, radial, and tibial).

Results: Cryoneurolysis was performed for 277 nerves (99 mixed motor sensory), on 113 patients (59 F, 54 M, average age 54.4 yrs). One patient had a local skin infection and two patients had bruising or swelling; all resolved within 1 mo. Nine reported nerve pain or dysesthesia (two motor, seven mixed motor sensory nerves). Four received no treatment, four oral or topical medications, two perineural injections, one botulinum toxin. Three patients' symptoms remained until 3 mos and one had numbness at six. One patient had botulinum toxin injections for cramping. All had at minimum 3-mo follow-up; seven withdrew (x̄ = 5.4 mos), four passed away. None of these 11 reported adverse effects.

Conclusions: A total of 96.75% of nerve treatments had no pain or dysesthesias beyond treatment. Few had pain or numbness beyond 3 mos. Cryoneurolysis has potential to be a safe spasticity treatment with manageable adverse effects.

Trial registration: ClinicalTrials.gov NCT04670783.

Keywords: Adverse Effects; Cryoneurolysis; Nerve Block; Safety.

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Conflict of interest statement

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

References

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