title: Percutaneous Image-Guided Cryoablation for the Treatment of Phantom Limb Pain in Amputees: A Pilot Study.
abstract: OBJECTIVE
  To prospectively evaluate percutaneous image-guided nerve cryoablation for treatment of refractory phantom limb pain (PLP) in a pilot cohort for purposes of deriving parameters to design a larger, randomized, parallel-armed, controlled trial.
  
  
  METHODS
  From January 2015 to January 2016, 21 patients with refractory PLP underwent image-guided percutaneous cryoneurolysis procedures. Visual analog scale scores were documented at baseline and 7, 45, and 180 days after the procedure. Responses to a modified Roland Morris Disability Questionnaire were documented at baseline and 7 and 45 days after the procedure.
  
  
  RESULTS
  Technical success rate of the procedures was 100%. There were 6 (29%) minor procedure-related complications. Disability scores decreased from a baseline mean of 11.3 to 3.3 at 45-day follow-up (95% confidence interval 5.8, 10.3; P < .0001). Pain intensity scores decreased from a baseline mean of 6.2 to 2.0 at long-term follow-up (95% confidence interval 2.8, 5.6; P < .0001).
  
  
  CONCLUSIONS
  Image-guided percutaneous nerve cryoablation is feasible and safe and may represent a new efficacious therapeutic option for patients with phantom pains related to limb loss.
authors.affiliation: Division of Interventional Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322. Electronic address: john.david.prologo@emory.edu.
authors.forename: J David
authors.initials: JD
authors.lastname: Prologo
authors.affiliation: Division of Interventional Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Gilliland
authors.affiliation: Division of Interventional Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
authors.forename: Michael
authors.initials: M
authors.lastname: Miller
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
authors.forename: Paul
authors.initials: P
authors.lastname: Harkey
authors.affiliation: Emory Clinic, Atlanta, Georgia.
authors.forename: Jackie
authors.initials: J
authors.lastname: Knight
authors.affiliation: Division of Interventional Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
authors.forename: Darren
authors.initials: D
authors.lastname: Kies
authors.affiliation: Division of Interventional Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
authors.forename: C Matthew
authors.initials: CM
authors.lastname: Hawkins
authors.affiliation: Emory Clinic, Atlanta, Georgia.
authors.forename: David
authors.initials: D
authors.lastname: Corn
authors.affiliation: Department of Orthopaedic Surgery, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
authors.forename: David K
authors.initials: DK
authors.lastname: Monson
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
authors.forename: Faramarz
authors.initials: F
authors.lastname: Edalat
authors.affiliation: Division of Interventional Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
authors.forename: Sean
authors.initials: S
authors.lastname: Dariushnia
authors.affiliation: Department of Surgery, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322.
authors.forename: Luke
authors.initials: L
authors.lastname: Brewster
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000674:Amputees / Q000523:psychology; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D003714:Denervation / Q000009:adverse effects / Q000379:methods*; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D005845:Georgia; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D058748:Pain Perception; D017933:Peripheral Nervous System / Q000503:physiopathology / Q000601:surgery*; D010591:Phantom Limb / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography