Outcomes Following Ultrasound-guided Percutaneous Cryoneurolysis for the Treatment of Spasticity

Spasticity is a manifestation of upper motor neuron disease which often impacts function, pain, and quality of life. Given the limited treatment modalities, exploring new interventions for spasticity management is imperative. This retrospective chart review study aims to review outcomes following ultrasound-guided percutaneous cryoneurolysis for the treatment of spasticity in patients in an outpatient neurorehabilitation clinic. All patients (n=22) underwent diagnostic lidocaine injection followed by cryoneurolysis of upper and/or lower extremity nerves. Outcomes included Modified Ashworth Scale (MAS) scores at baseline and >3 months post-procedure (average follow-up of 4.36 mo after cryoneurolysis), and patient-reported changes in function, pain, and side effects >3 months after cryoneurolysis. MAS data (n=19) showed statistically significant improvement from a median baseline of 3 (IQR 2) to follow-up of 1+ (IQR 1; W=7, P<0.05). Subjective functional improvements (Figure 2) were reported in 94% (n=18) of patients and pain relief was noted in 81% (n=16). Side effects were reported in 32% of patients and included pain, dysesthesias, and weakness. Ultrasound-guided cryoneurolysis appears to be a promising, minimally invasive treatment for spasticity and may serve as a useful adjunct or alternative for refractory spasticity.