Download PDF
Semin intervent Radiol 2019; 36(05): 374-380
DOI: 10.1055/s-0039-1696705
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Interventional Cryoneurolysis: What Is the Same, What Is Different, What Is New?

Ross W. Bittman
1   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Keywan Behbahani
1   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
Felix Gonzalez
1   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
,
J. David Prologo
1   Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations
Further Information

Publication History

Publication Date:
02 December 2019 (online)

Also available at
    Permissions and Reprints

Abstract

Cryoneurolysis is the deliberate application of cold temperatures to nerves for therapeutic purposes. The idea of treating pain with this technique is thousands of years old and has evolved over time through the application of surgical techniques, nerve stimulation and/or landmark guidance, and through device development. Recent integration of the interventional radiology skill set to this space has unlocked a myriad of opportunities—primarily through a unique ability to percutaneously access deep structures in the body with accuracy and precision, and the capacity to monitor ablation zones. Understanding of the specific neurohistological process that follows targeted cryoneurolysis leads to new options for treating patients in pain without drugs and opens doors for the potential modification of a wide array of disease states.

Keywords

interventional - cryoneurolysis - cryoanalgesia - cryoablation
 

  • References

  • 1 Cooper SM, Dawber RP. The history of cryosurgery. J R Soc Med 2001; 94 (04) 196-201
    CrossrefPubMedGoogle Scholar
  • 2 Ilfeld BM, Preciado J, Trescot AM. Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves. Expert Rev Med Devices 2016; 13 (08) 713-725
    CrossrefPubMedGoogle Scholar
  • 3 Trescot AM. Cryoanalgesia in interventional pain management. Pain Physician 2003; 6 (03) 345-360
    PubMedGoogle Scholar
  • 4 Lloyd JW, Barnard JDW, Glynn CJ. Cryoanalgesia. A new approach to pain relief. Lancet 1976; 2 (7992): 932-934
    PubMedGoogle Scholar
  • 5 Wood GJ, Lloyd JW, Bullingham RE, Britton BJ, Finch DR. Postoperative analgesia for day-case herniorrhaphy patients. A comparison of cryoanalgesia, paravertebral blockade and oral analgesia. Anaesthesia 1981; 36 (06) 603-610
    CrossrefPubMedGoogle Scholar
  • 6 Fanelli RD, DiSiena MR, Lui FY, Gersin KS. Cryoanalgesic ablation for the treatment of chronic postherniorrhaphy neuropathic pain. Surg Endosc 2003; 17 (02) 196-200
    CrossrefPubMedGoogle Scholar
  • 7 Nelson KM, Vincent RG, Bourke RS. , et al. Intraoperative intercostal nerve freezing to prevent postthoracotomy pain. Ann Thorac Surg 1974; 18 (03) 280-285
    CrossrefPubMedGoogle Scholar
  • 8 Graves CE, Moyer J, Zobel MJ. , et al. Intraoperative intercostal nerve cryoablation during the Nuss procedure reduces length of stay and opioid requirement: a randomized clinical trial. J Pediatr Surg 2019; DOI: 10.1016/j.jpedsurg.2019.02.057. . [Epub ahead of print]
    CrossrefPubMedGoogle Scholar
  • 9 Keller BA, Kabagambe SK, Becker JC. , et al. Intercostal nerve cryoablation versus thoracic epidural catheters for postoperative analgesia following pectus excavatum repair: Preliminary outcomes in twenty-six cryoablation patients. J Pediatr Surg 2016; 51 (12) 2033-2038
    CrossrefPubMedGoogle Scholar
  • 10 Pastor J, Morales P, Cases E. , et al. Evaluation of intercostal cryoanalgesia versus conventional analgesia in postthoracotomy pain. Respiration 1996; 63 (04) 241-245
    CrossrefPubMedGoogle Scholar
  • 11 Wood GJ, Lloyd JW, Bullingham RE, Britton BJ, Finch DR. Postoperative analgesia for day-case herniorrhaphy patients. A comparison of cryoanalgesia, paravertebral blockade and oral analgesia. Anaesthesia 1981; 36 (06) 603-610
    CrossrefPubMedGoogle Scholar
  • 12 Wood GJ, Lloyd JW, Evans PJ, Bullingham RE, Britton BJ, Finch DR. Cryoanalgesia and day-case herniorrhaphy. Lancet 1979; 2 (8140): 479
    PubMedGoogle Scholar
  • 13 Khiroya RC, Davenport HT, Jones JG. Cryoanalgesia for pain after herniorrhaphy. Anaesthesia 1986; 41 (01) 73-76
    CrossrefPubMedGoogle Scholar
  • 14 Callesen T, Bech K, Thorup J. , et al. Cryoanalgesia: effect on postherniorrhaphy pain. Anesth Analg 1998; 87 (04) 896-899
    PubMedGoogle Scholar
  • 15 Evans PJ, Lloyd JW, Jack TM. Cryoanalgesia for intractable perineal pain. J R Soc Med 1981; 74 (11) 804-809
    CrossrefPubMedGoogle Scholar
  • 16 Radnovich R, Scott D, Patel AT. , et al. Cryoneurolysis to treat the pain and symptoms of knee osteoarthritis: a multicenter, randomized, double-blind, sham-controlled trial. Osteoarthritis Cartilage 2017; 25 (08) 1247-1256
    CrossrefPubMedGoogle Scholar
  • 17 Kim CH, Hu W, Gao J, Dragan K, Whealton T, Julian C. Cryoablation for the treatment of occipital neuralgia. Pain Physician 2015; 18 (03) E363-E368
    CrossrefPubMedGoogle Scholar
  • 18 Moesker AA, Karl HW, Trescot AM. Treatment of phantom limb pain by cryoneurolysis of the amputated nerve. Pain Pract 2014; 14 (01) 52-56
    CrossrefPubMedGoogle Scholar
  • 19 Cameron MG, Kersten C, Vistad I, Fosså S, Guren MG. Palliative pelvic radiotherapy of symptomatic incurable rectal cancer - a systematic review. Acta Oncol 2014; 53 (02) 164-173
    CrossrefPubMedGoogle Scholar
  • 20 Caraceni A, Martini C, Zecca E. , et al; Working Group of an IASP Task Force on Cancer Pain. Breakthrough pain characteristics and syndromes in patients with cancer pain. An international survey. Palliat Med 2004; 18 (03) 177-183
    CrossrefPubMedGoogle Scholar
  • 21 Hibner M, Desai N, Robertson LJ, Nour M. Pudendal neuralgia. J Minim Invasive Gynecol 2010; 17 (02) 148-153
    CrossrefPubMedGoogle Scholar
  • 22 Wadhwa V, Hamid AS, Kumar Y, Scott KM, Chhabra A. Pudendal nerve and branch neuropathy: magnetic resonance neurography evaluation. Acta Radiol 2017; 58 (06) 726-733
    CrossrefPubMedGoogle Scholar
  • 23 Prologo JD, Lin RC, Williams R, Corn D. Percutaneous CT-guided cryoablation for the treatment of refractory pudendal neuralgia. Skeletal Radiol 2015; 44 (05) 709-714
    CrossrefPubMedGoogle Scholar
  • 24 Rhame EE, Levey KA, Gharibo CG. Successful treatment of refractory pudendal neuralgia with pulsed radiofrequency. Pain Physician 2009; 12 (03) 633-638
    PubMedGoogle Scholar
  • 25 Prologo JD, Gilliland CA, Miller M. , et al. Percutaneous image-guided cryoablation for the treatment of phantom limb pain in amputees: a pilot study. J Vasc Interv Radiol 2017; 28 (01) 24-34.e4
    CrossrefPubMedGoogle Scholar
  • 26 Bonham LW, Phelps A, Rosson GD, Fritz J. MR imaging-guided cryoneurolysis of the sural nerve. J Vasc Interv Radiol 2018; 29 (11) 1622-1624
    CrossrefPubMedGoogle Scholar
  • 27 Joshi DH, Thawait GK, Del Grande F, Fritz J. MRI-guided cryoablation of the posterior femoral cutaneous nerve for the treatment of neuropathy-mediated sitting pain. Skeletal Radiol 2017; 46 (07) 983-987
    CrossrefPubMedGoogle Scholar
  • 28 Kim PS, Ferrante FM. Cryoanalgesia: a novel treatment for hip adductor spasticity and obturator neuralgia. Anesthesiology 1998; 89 (02) 534-536
    CrossrefPubMedGoogle Scholar
  • 29 Yoon JH, Grechushkin V, Chaudhry A, Bhattacharji P, Durkin B, Moore W. Cryoneurolysis in patients with refractory chronic peripheral neuropathic pain. J Vasc Interv Radiol 2016; 27 (02) 239-243
    CrossrefPubMedGoogle Scholar
  • 30 Ilfeld BM, Gabriel RA, Trescot AM. Ultrasound-guided percutaneous cryoneurolysis for treatment of acute pain: could cryoanalgesia replace continuous peripheral nerve blocks?. Br J Anaesth 2017; 119 (04) 703-706
    CrossrefPubMedGoogle Scholar
  • 31 Gabriel RA, Finneran IV JJ, Trescot AM, Ilfeld BM. Ultrasound-guided percutaneous cryoneurolysis for postoperative analgesia after limb amputation: a case series. A A Pract 2019; 12 (07) 231-234
    PubMedGoogle Scholar
  • 32 Friedman T, Richman D, Adler R. Sonographically guided cryoneurolysis: preliminary experience and clinical outcomes. J Ultrasound Med 2012; 31 (12) 2025-2034
    CrossrefPubMedGoogle Scholar
  • 33 Campos NA, Chiles JH, Plunkett AR. Ultrasound-guided cryoablation of genitofemoral nerve for chronic inguinal pain. Pain Physician 2009; 12 (06) 997-1000
    PubMedGoogle Scholar
  • 34 Birkenmaier C, Veihelmann A, Trouillier H. , et al. Percutaneous cryodenervation of lumbar facet joints: a prospective clinical trial. Int Orthop 2007; 31 (04) 525-530
    CrossrefPubMedGoogle Scholar
  • 35 Wolter T, Deininger M, Hubbe U, Mohadjer M, Knoeller S. Cryoneurolysis for zygapophyseal joint pain: a retrospective analysis of 117 interventions. Acta Neurochir (Wien) 2011; 153 (05) 1011-1019
    CrossrefPubMedGoogle Scholar
  • 36 Wolter T, Kleinmann B, Knoeller S. Cryoneurolysis for the treatment of cervical facet joint syndrome: a technical note. J Pain Res 2018; 11: 1165-1169
    CrossrefPubMedGoogle Scholar
  • 37 Bärlocher CB, Krauss JK, Seiler RW. Kryorhizotomy: an alternative technique for lumbar medial branch rhizotomy in lumbar facet syndrome. J Neurosurg 2003; 98 (1, Suppl): 14-20
    CrossrefPubMedGoogle Scholar
  • 38 Staender M, Maerz U, Tonn JC, Steude U. Computerized tomography-guided kryorhizotomy in 76 patients with lumbar facet joint syndrome. J Neurosurg Spine 2005; 3 (06) 444-449
    CrossrefPubMedGoogle Scholar
  • 39 Amid PK. Causes, prevention, and surgical treatment of postherniorrhaphy neuropathic inguinodynia: triple neurectomy with proximal end implantation. Hernia 2004; 8 (04) 343-349
    CrossrefPubMedGoogle Scholar
  • 40 Lee KS, Sin JM, Patil PP. , et al. Ultrasound-guided microwave ablation for the management of inguinal neuralgia: a preliminary study with 1-year follow-up. J Vasc Interv Radiol 2019; 30 (02) 242-248
    CrossrefPubMedGoogle Scholar
  • 41 Martin C, Nolen H, Podolnick J, Wang R. Current and emerging therapies in premature ejaculation: where we are coming from, where we are going. Int J Urol 2017; 24 (01) 40-50
    CrossrefPubMedGoogle Scholar
  • 42 David Prologo J, Snyder LL, Cherullo E, Passalacqua M, Pirasteh A, Corn D. Percutaneous CT-guided cryoablation of the dorsal penile nerve for treatment of symptomatic premature ejaculation. J Vasc Interv Radiol 2013; 24 (02) 214-219
    CrossrefPubMedGoogle Scholar
  • 43 Prologo JDLE, Lin E, Horesh Bergquist S. , et al. Percutaneous CT-guided cryovagotomy in patients with Class I or Class II obesity: a pilot trial. Obesity (Silver Spring) 2019; 27 (08) 1255-1265
    CrossrefPubMedGoogle Scholar
  • 44 Burnett MG, Zager EL. Pathophysiology of peripheral nerve injury: a brief review. Neurosurg Focus 2004; 16 (05) E1
    PubMedGoogle Scholar
  • 45 Caillaud M, Richard L, Vallat JM, Desmoulière A, Billet F. Peripheral nerve regeneration and intraneural revascularization. Neural Regen Res 2019; 14 (01) 24-33
    CrossrefPubMedGoogle Scholar
  • 46 Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain 1951; 74 (04) 491-516
    CrossrefPubMedGoogle Scholar
  • 47 Seddon HJ. Classification of nerve injuries. BMJ 1942; 2 (4260): 237-239
    CrossrefPubMedGoogle Scholar
  • 48 The U.S. Department of Health and Human Services. Pain Management Best Practices Inter-Agency Task Force Report. 2019 . Available at: https://www.hhs.gov/ash/advisory-committees/pain/index.html . Accessed August 16, 2019
    PubMedGoogle Scholar
  • 49 Moorjani N, Zhao F, Tian Y, Liang C, Kaluba J, Maiwand MO. Effects of cryoanalgesia on post-thoracotomy pain and on the structure of intercostal nerves: a human prospective randomized trial and a histological study. Eur J Cardiothorac Surg 2001; 20 (03) 502-507
    CrossrefPubMedGoogle Scholar
  • 50 Kilcoyne A, Frenk NE, Arellano RS. Percutaneous cryoablation of a metastatic right external iliac lymph node with associated injury to the femoral nerve. J Vasc Interv Radiol 2016; 27 (04) 611-612
    CrossrefPubMedGoogle Scholar
  • 51 Auloge P, Cazzato RL, Rousseau C. , et al. Complications of percutaneous bone tumor cryoablation: a 10-year experience. Radiology 2019; 291 (02) 521-528
    CrossrefPubMedGoogle Scholar
  • 52 Johnson CMJ, Manyapu S, Hawkins C, Singer A, Prologo JD. Abstract No 410 Natural history of motor nerve cryoablation: a retrospective cohort analysis. J Vasc Interv Radiol 2019; 30 (03) s176
    PubMedGoogle Scholar
  • 53 Kingery WS, Lu JD, Roffers JA, Kell DR. The resolution of neuropathic hyperalgesia following motor and sensory functional recovery in sciatic axonometric mononeuropathies. Pain 1994; 58 (02) 157-168
    CrossrefPubMedGoogle Scholar
  • 54 Hsu M, Stevenson FF. Wallerian degeneration and recovery of motor nerves after multiple focused cold therapies. Muscle Nerve 2015; 51 (02) 268-275
    CrossrefPubMedGoogle Scholar
  • 55 Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain--United States, 2016. JAMA 2016; 315 (15) 1624-1645
    CrossrefPubMedGoogle Scholar