Cryoneurolysis and Quadriplegia: A Case Report on Pain and Severe Spasticity Management.
Laura Schatz, Samuel Herzog, Mahdis Hashemi and 1 others
PMID 39822204WHAT IT FOUND
A man with long-standing quadriplegia and severe spasticity had cryoneurolysis to hip and hand muscles.
His hip and knee range of motion and hand function improved for months, and he regained some daily independence. This is one person's story, not proof the treatment works for others.
Key findings
01Cryoneurolysis to lower limb nerves and muscles produced immediate and sustained improvements in hip abduction and knee extension range of motion, though muscle tone did not drop significantly.
02Upper limb cryoneurolysis improved wrist extension and hand function, allowing a cylinder grip and better hygiene, with gains maintained at nine months.
03Effects on the legs waned as nerves regrew, requiring a repeat procedure at nine months to re-establish range of motion gains.
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 it cannot show that cryoneurolysis works for anyone else. The patient had severe hip osteoarthritis and a fixed deformity, so results may not apply to people without those structural problems. He was already receiving high-dose off-label botulinum toxin, oral baclofen, diazepam, and zopiclone, so the independent contribution of cryoneurolysis cannot be separated from the other treatments. Muscle tone did not decrease significantly despite range of motion gains, and the lower limb effects waned by nine months, requiring retreatment. Follow-up was short, at 11 months, and no control group was used.
Declared interests
One author, Paul Winston, has received grants and educational funding and served on advisory boards for AbbVie, Ipsen, Merz, and Pacira. Pacira is the supplier of the Iovera cryoneurolysis system used in the case. The other authors declared nothing.
The easy way to misread this
Do not read this as evidence that cryoneurolysis reliably reduces spasticity or restores function. It is one person's experience with a complex, long-standing condition and multiple concurrent treatments. Muscle tone did not fall significantly, and the leg improvements required a repeat procedure at nine months.