Moon John T, Li Hanzhou, Cooper Maxwell, Huang Junjian, Prologo John David
Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Cardiovasc Intervent Radiol. 2025 Aug 25. doi: 10.1007/s00270-025-04114-7.
Posttraumatic painful mononeuropathy involves a permanent structural change in the affected nerve. Clinical and animal models have shown that exposure of nerves to specific cold temperatures for distinct time periods can induce: cessation of signal transduction, Wallerian degeneration, and predictable axonal regeneration. It is hypothesized that these processes may return a structurally altered painful nerve to a non-pathologic or normal state. We present four patients in which percutaneous cryoneurolysis was employed with the intent of inducing regeneration and repair. Primary outcomes included return of nerve function, pain relief, and peri/postprocedural adverse events. All patients demonstrated return of normal nerve function and significant pain reduction without major complications or adverse events. Whether or not structural abnormalities were repaired can only be inferred via interpretation of symptom improvement.
创伤后疼痛性单神经病涉及受影响神经的永久性结构改变。临床和动物模型表明，将神经暴露于特定低温不同时间段可诱导：信号转导停止、华勒氏变性和可预测的轴突再生。据推测，这些过程可能使结构改变的疼痛神经恢复到非病理或正常状态。我们报告了4例采用经皮冷冻神经溶解术以诱导再生和修复的患者。主要结局包括神经功能恢复、疼痛缓解以及围手术期/术后不良事件。所有患者均表现出正常神经功能恢复且疼痛显著减轻，无重大并发症或不良事件。结构异常是否得到修复只能通过症状改善情况来推断。
