Ilfeld Brian M, Preciado Jessica, Trescot Andrea M
a Department of Anesthesiology , University California San Diego , San Diego , CA , USA.
b Myoscience, Inc ., Fremont , CA , USA.
Expert Rev Med Devices. 2016 Aug;13(8):713-25. doi: 10.1080/17434440.2016.1204229. Epub 2016 Jul 13.
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.
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.
冷冻神经lysis是直接应用低温来可逆性地消融周围神经以缓解疼痛。一种带有小口径探头和集成皮肤加热器的手持式冷冻神经lysis设备的最新进展拓宽了临床应用范围,包括对浅表神经的治疗,进一步实现了对术前疼痛、术后疼痛、慢性疼痛和肌肉运动障碍的治疗。
冷冻神经lysis是将低温直接作用于周围神经,由于华勒变性和神经再生导致可逆性消融。过去50年的使用证明并发症和不良反应的发生率极低。传统上,冷冻探头是通过手术切口应用的;但是,最近的技术进步允许经皮给药。一种新型手持设备现已在美国获批使用。冷冻神经lysis已被用于治疗术后和慢性疼痛状态以及痉挛。
美国医疗保健系统的变化,如推动减少阿片类药物的使用和纳入诊断相关组代码,以及最近的技术进步,包括一种手持设备,可在保护皮肤免受损伤的同时治疗浅表神经,可能有助于冷冻神经lysis在周围神经治疗中的复兴。