MacRae Fraser, Boissonnault Eve, Hashemi Mahdis, Winston Paul
Western University, School of Physical Therapy, London, Canada.
Vancouver Island Health Authority, Victoria, Canada.
Arch Rehabil Res Clin Transl. 2023 Jan 25;5(1):100256. doi: 10.1016/j.arrct.2023.100256. eCollection 2023 Mar.
Osteoarthritis is a leading cause of disability, typically treated with exercise, analgesics, injections, or surgeries. Cryoneurolysis is an established technique for the treatment of pain, including osteoarthritis that may provide an alternative for patients in whom surgery is not appropriate and conservative measures have failed. We present our experience with a 78-year-old man with severe pain from bilateral glenohumeral osteoarthritis. Their condition is complicated by several concurrent diagnoses, leaving them ineligible for surgical intervention, despite pharmacologic treatments proving insufficient to manage their pain. As an alternative, bilateral cryoneurolysis of the suprascapular nerve was performed at the suprascapular notch. Pain and disability scores both lessened on the Brief Pain Inventory Score, Disabilities of the Arm Shoulder and Hand (change of 9 points after 170 days) as well as the Shoulder Pain and Disability Index (change of 19 points after 170 days). The patient had improved active and passive range of motion for flexion, abduction, and external rotation of the shoulder. Improvements endured to follow-up at 170 days. There were no negative side effects as a result of the procedure.
骨关节炎是导致残疾的主要原因,通常采用运动、镇痛药、注射治疗或手术治疗。冷冻神经lysis是一种已确立的治疗疼痛的技术,包括骨关节炎,对于不适合手术且保守治疗失败的患者可能是一种替代方法。我们介绍了一位78岁男性双侧肩肱关节骨关节炎剧痛患者的治疗经验。他们的病情因多种并发诊断而复杂化,尽管药物治疗证明不足以控制疼痛,但仍不符合手术干预条件。作为替代方案,在肩胛上切迹处对肩胛上神经进行双侧冷冻神经lysis。疼痛和残疾评分在简短疼痛量表、手臂肩部和手部残疾量表(170天后变化9分)以及肩部疼痛和残疾指数(170天后变化19分)上均有所降低。患者肩部屈曲、外展和外旋的主动和被动活动范围得到改善。改善情况持续到170天的随访。该手术没有产生负面副作用。