Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

ABSTRACT

Introduction: Cryoneurolysis is the direct application of low temperatures to reversibly ablate peripheral nerves to provide pain relief. Recent development of a handheld cryoneurolysis device with small gauge probes and an integrated skin warmer broadens the clinical applications to include treatment of superficial nerves, further enabling treatments for pre-operative pain, post-surgical pain, chronic pain, and muscle movement disorders.

Areas covered: Cryoneurolysis is the direct application of cold temperatures to a peripheral nerve, resulting in reversible ablation due to Wallerian degeneration and nerve regeneration. Use over the last 50 years attests to a very low incidence of complications and adverse effects. Cryoprobes have traditionally been applied through a surgical incision; but, recent technical advances allow percutaneous administration. A new hand-held device is now approved for use within the United States. Cryoneurolysis has been used to treat postoperative and chronic pain states as well as spasticity.

Expert commentary: Changes in the US healthcare system such as a push for the reduction of opioid use and the incorporation of Diagnostic Related Group codes, as well as recent technological advances including a handheld unit that allows for treatment of superficial nerves while protecting the skin from damage, may contribute to the resurgence of cryoneurolysis for the treatment of peripheral nerves.

KEYWORDS:

• Cryoneurolysis
• cryoanalgesia
• cryoneuroablation
• sensory nerves
• postoperative analgesia
• spasticity
• chronic pain

Declaration of interest

B. Ilfeld has received funding for his research from SPR Therapeutics, Baxter Healthcare, Smiths Medical, and Summit Medical, Teleflex Medical, Myoscience, Pacira Pharmaceuticals. B. Ilfeld has also acted as a consultant to Pacira Pharmaceuticals. J. Preciado, is an employee of Myoscience, Inc. A. Trescot is a consultant to Epimed/Wallach, Metrum Cryoflex, and Myoscience, as well as a paid scientific advisor to Atricure. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This work was supported by the Myoscience [N/A: Dr. Preciado is an employee of Myoscience.].