Percutaneous Image-Guided Cryoablation for the Treatment of Phantom Limb Pain in Amputees: A Pilot Study |
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| Affiliation: | 1. Division of Interventional Radiology, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322;2. Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322;3. Department of Orthopaedic Surgery, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322;4. Department of Surgery, Emory University School of Medicine, 1364 Clifton Road, NE Suite D112, Atlanta, GA 30322;5. Emory Clinic, Atlanta, Georgia;1. Institute for Surgical Technology and Biomechanics, University of Bern, Bern Switzerland;2. Angiology Department, Kantonsspital Aarau, Aarau, Switzerland;1. Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany;2. Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany;3. Department of Internal Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany;4. Clinical Registry Unit, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany;1. Department of Radiology, Stanford University Medical Center, Stanford, California;2. Stanford School of Medicine, Stanford University, 300 Pasteur Dr., Room H-1307, MC 5621, Stanford, CA 94305-5621;1. Division of Interventional Radiology, Miami Cardiac and Vascular Institute, Miami, Florida;2. Department of Medical and Population Health Sciences Research, Herbert Wertheim College of Medicine, Florida International University, Miami, Florida;3. Division of Cardiology, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Republic of Korea;1. Department of Urology, University of Miami Miller School of Medicine, 1611 NW 12th Avenue #W279, Miami, Florida 33136;2. Department of Radiology, Division of Vascular Interventional Radiology, University of Miami Miller School of Medicine, 1611 NW 12th Avenue #W279, Miami, Florida 33136;3. Interventional Radiology Section, University of Sao Paulo, Sao Paulo, Brazil |
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| Abstract: | PurposeTo 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.Materials and MethodsFrom 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.ResultsTechnical 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).ConclusionsImage-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. |
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