title: Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves.
abstract: BACKGROUND
  Cryoneurolysis is the direct application of low temperatures to reversibly ablate peripheral nerves to provide pain relief. Recent development of a handheld cryoneurolysis device with small gauge probes and an integrated skin warmer broadens the clinical applications to include treatment of superficial nerves, further enabling treatments for pre-operative pain, post-surgical pain, chronic pain, and muscle movement disorders.
  
  
  METHODS
  Cryoneurolysis is the direct application of cold temperatures to a peripheral nerve, resulting in reversible ablation due to Wallerian degeneration and nerve regeneration. Use over the last 50 years attests to a very low incidence of complications and adverse effects. Cryoprobes have traditionally been applied through a surgical incision; but, recent technical advances allow percutaneous administration. A new hand-held device is now approved for use within the United States. Cryoneurolysis has been used to treat postoperative and chronic pain states as well as spasticity. Expert commentary: Changes in the US healthcare system such as a push for the reduction of opioid use and the incorporation of Diagnostic Related Group codes, as well as recent technological advances including a handheld unit that allows for treatment of superficial nerves while protecting the skin from damage, may contribute to the resurgence of cryoneurolysis for the treatment of peripheral nerves.
authors.affiliation: a Department of Anesthesiology , University California San Diego , San Diego , CA , USA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Ilfeld
authors.affiliation: b Myoscience, Inc ., Fremont , CA , USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Preciado
authors.affiliation: c Alaska Pain Management Center , Wasilla , AK , USA.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Trescot
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D009046:Motor Neurons / Q000473:pathology*; D010525:Peripheral Nerves / Q000473:pathology*; D015203:Reproducibility of Results; D011984:Sensory Receptor Cells / Q000473:pathology*
keywords: Cryoneurolysis; chronic pain; cryoanalgesia; cryoneuroablation; postoperative analgesia; sensory nerves; spasticity