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Cryoneurolysis contributes to significant improvement in phantom limb pain, with the added benefit of reducing medication reliance.
A systematic review issued in "Neurology" has found that cryoneurolysis—a minimally invasive technique that temporarily disables nerves by freezing—may offer substantial pain relief for individuals suffering from phantom limb pain (PLP).
Conducted in accordance with PRISMA 2020 guidelines, the review comprehensively analyzed existing literature to explore the efficacy of cryoneurolysis (also known as cryoanalgesia or cryoneuroablation) in PLP management. A total of 200 studies were initially identified from major scientific databases including PubMed, Embase, Cochrane Library, and Web of Science. Out of 200 identified articles, 5 met the criteria for inclusion, and 4 were suitable for pooled statistical analysis.
The pooled results revealed a Cohen’s d effect size of 1.55 (95% confidence interval [CI]: 0.24 to 2.87; p = 0.02), indicating a large and statistically significant reduction in pain scores post-treatment. Patients reported improvements in pain severity on a 10-point scale, underlining the clinical significance of cryoneurolysis in alleviating PLP. One additional study, a case report not included in the pooled analysis, showed a dramatic drop in pain from 9/10 to 1/10 just 1 week after treatment.
Cryoneurolysis works by targeting and temporarily disabling specific peripheral nerves implicated in pain transmission. By freezing these nerves, the therapy disrupts abnormal pain signals associated with phantom limb sensations, offering relief without the side effects commonly linked to systemic medications. Importantly, the review also suggests that successful cryoneurolysis treatment may help curtail patients’ dependence on pharmacologic pain management strategies, which often include opioids or other long-term medications with potential adverse effects.
The researchers emphasize the need for further high-quality, large-scale clinical trials to confirm and refine cryoneurolysis protocols for broader application. If validated, cryoneurolysis could become a vital tool in the pain management arsenal for amputees suffering from PLP.
Neurology
Cryoneurolysis for Post-amputation Phantom Limb Pain: A Systematic Review and Pooled Analysis (P5-7.002)
Brandon Goodwin et al.
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