Interventional Cryoneurolysis Studied for Management of Pain After Traumatic Injury

June 8, 2022—The Society of Interventional Radiology (SIR) announced that new research suggests damaged nerves can be regenerated through interventional cryoneurolysis. The technique, which is the application of a frozen needle under advanced imaging guidance performed by an interventional radiologist, offers hope to patients in persistent pain after a traumatic injury.

The study, “Percutaneously induced neuroregeneration for the management of chronic painful mononeuropathies secondary to trauma” by J. David Prologo, MD, et al, will be presented at the SIR 2022, the society’s annual scientific meeting held in June 11-16 in Boston, Massachusetts.

Dr. Prologo, MD, who is an interventional radiologist and associate professor at Emory University School of Medicine in Atlanta, Georgia, commented in the SIR press release, “The idea that we can induce regeneration of damaged nerves simply by placing a cold needle through the skin under imaging guidance is extremely exciting. This research answers the call from United States legislators and specialty medical societies to develop alternatives to opioids for the management of pain.”

According to SIR, eight patients with chronic nerve pain related to a previous trauma were treated with CT-guided interventional cryoneurolysis by investigators at Emory University. CT-guided cryoneurolysis freezes the damaged nerves, causing them to degenerate and lose function.

“What happens next is almost magical,” stated Dr. Prologo. “If the nerve is exposed to the correct amount of cold, over the correct area, for the right amount of time, it will regenerate—replacing the previously damaged nerve with a healthy one.”

As summarized in the SIR press release, the study results showed that the average time from traumatic injury to the procedure was 9.5 years. There were no procedure-related complications or adverse events, and all patients returned to their baseline strength over time, which confirms regeneration of the targeted nerve. In six of the eight patients, pain symptoms dramatically improved after regeneration, demonstrated as a collective decrease of 4.6 points in visual analog scale pain scores.

Dr. Prologo believes that the interventional radiology skillset applied to nerve freezing has many applications for treatment of complex pain. He concluded in the society’s press release, “We are using this regeneration technique not only to manage nerve pain induced by trauma—but also for pudendal neuralgia, post mastectomy pain, postsurgical pain, and many other conditions historically managed with narcotics. Interventional radiologists can place these needles safely in precise locations all over the body, allowing access to pain generators that were previously unreachable and giving hope to patients who struggle with pain.”