Cryoneurolysis for Managing Spasticity in Multiple Sclerosis: A Case Report Demonstrating Sustained Functional Gains and Cost-Effectiveness.

This is a single case report, so the results cannot be generalized to the broader MS population. The patient's MS was progressive, and her function declined overall (e.g., moving to long-term care), so the spasticity improvements did not necessarily translate to long-term functional independence. There was no control group or comparison to other treatments. The cost-effectiveness analysis compares this single case to average costs of botulinum toxin, which may not reflect individual patient responses or institutional variations.

One author received traveling support from Pacira Biosciences, the manufacturer of the Iovera cryoneurolysis system used in the case. Another author received honorariums and educational grants from Pacira Biosciences and other companies that produce spasticity treatments (Abbvie, Ipsen, Merz).

Do not assume cryoneurolysis will provide sustained functional gains or halt disability progression in MS. In this case, the patient’s disease continued to worsen despite spasticity management, and she eventually required long-term care. The improvements were in passive range of motion and pain, not necessarily in active function or independence.