Measuring the Efficacy of Percutaneous Cryoneurolysis in Participants With Refractory or Plateaued Shoulder, Elbow, Wrist, or Finger Spasticity.

It was a single-centre observational pilot in which each participant served as their own baseline control, so change over time cannot be separated from natural variation, continued routine spasticity treatments, or other care. Not all participants completed every follow-up; some outcome measures had limited numbers, and follow-up visits fell within a 45-day window rather than exact times. Data collectors were not blinded, which could affect measurement. Participants could receive cryoneurolysis in multiple regions and later additional locations, so effects in one area may have influenced another. Three participants received botulinum toxin during follow-up, although all had maintained improvement before and after injection. The study targeted 50 participants for power but enrolled and treated 59; later analyses were based on small numbers at some time points. The diagnoses were predominantly stroke, so results may not apply to other causes of spasticity. Adverse-event data were not reported here because safety results were published separately.

Several authors had financial relationships with Pacira BioSciences, Inc., which makes one cryoneurolysis device: one author is an employee and owns stock, and others received research grants, travel support, educational grants, honoraria, consulting fees, or advisory board payments. Some authors also had relationships with AbbVie, Merz Therapeutics, and Ipsen. One author received funding per session from Island Health.

Do not read these changes as proof that cryoneurolysis caused them compared with continued usual care. This was an observational repeated-measures pilot in which each participant served as their own baseline control, routine spasticity treatments were not adjusted, and three participants received botulinum toxin during follow-up, so the contribution of cryoneurolysis alone cannot be separated.