Case Report: Perspective of a Caregiver on Functional Outcomes Following Bilateral Lateral Pectoral Nerve Cryoneurotomy to Treat Spasticity in a Pediatric Patient With Cerebral Palsy.
Jack Scobie, Paul Winston
PMID 36188857WHAT IT FOUND
In one non-verbal teenager with severe cerebral palsy, freezing the nerves to the chest muscles improved shoulder movement and made dressing, bathing, and wheelchair transfers easier for his caregiver.
Key findings
01Shoulder abduction range of motion improved from 86 to 133 degrees on the right and 90 to 139 degrees on the left one month after the procedure.
02The caregiver reported improvements in putting on and taking off shirts, washing the upper body, sitting in a wheelchair for three hours, transferring, and applying orthotics.
03Modified Ashworth Scores for muscle tone dropped from four to two at one month and to one plus at nine months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a single case report, so results cannot be generalized to other patients. The patient had complex medical issues including seizures and respiratory problems, which may have influenced outcomes or care needs. No control group or blinding was used, and the caregiver's report is subjective. The long-term duration of the effect is unknown, with the last follow-up at 9 months showing some regression on the left side.
Declared interests
One author (PW) has funding for a clinical trial in adults with spasticity for cryoneurotomy provided by Abbvie Allergan and Pacira.
The easy way to misread this
Do not assume this procedure will work for other patients. This is a single case report with no control group, and the patient had unique medical complexities. The improvement in one teenager does not prove efficacy for the broader population.