William Henry Moore MD, Abstract Co-Author: Research Grant, EDDA Technology, Inc Medical Board, EDDA Technology, Inc Research Grant, Galil Medical Ltd Research Grant, Endo Health Solutions Inc

Adam T. Ryan MD, Abstract Co-Author: Nothing to Disclose

Vadim Grechushkin MD, Abstract Co-Author: Nothing to Disclose

Armen Aivazi, Abstract Co-Author: Nothing to Disclose

Jung Hwoon Edward Yoon MD, Presenter: Nothing to Disclose

To evaluate the safety and efficacy of cryoneurolysis in patients with refactor peripheral neuropathic pain.

A prospective study was performed from July 2012 to April 2014. Patients were recruited who were referred for cryoneurolysis of the lower extremities. Ultrasound guidance of the involved nerves was used for imaging guidance. Percutaneous ablations were performed using an Percryo-17-R device (Endocare, Healthtronics, USA). The ablation technique was a single 3 minute freeze cycle with a single thaw cycle. Maximum negative temperature was documented during the procedure and complications were also documented. Patients pain levels were recorded on a 0-10 visual analog scale, before and immediately after the procedure then at 1 week, and at 1,3,6,9 and 12 months.

A total of 11 patients were recruited to this study. All underwent cryoneurolysis under-ultrasound guidance involving the nerves of the lower extremity including the posterior tibial, sural nerve, digital nerves, and saphenous nerves. The mean pain scale prior to the intervention was 9.0 +/- 1.1. The visual analog scale immediately after treatment was 2.0 +/- 1.8 with a pain score at 6 months with a pain score of 3.3 +/- 2.5. A wilcoxon rank sum test was performed and showed statically significant decrease in pain score comparing per and post procedural visual analog scale. There were no complications from these procedures.

There is a statically significant decrease in self-reported pain scale in patients with chronic refractory neuropathic pain. This decrease in pain level is sustained up to 9 months. In our experience the neuropathic pain will recur and repeat therapy is equally effective.

Cryoneurolysis is an additional therapy which can be alleviate severe chronic neuropathic pain in patients who are refectory to standard treatments.

Moore, W, Ryan, A, Grechushkin, V, Aivazi, A, Yoon, J, Cryoneurolysis in Patients with Chronic Peripheral Refractory Neuropathic Pain.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007398.html