1. Percutaneous Image-Guided Cryoablation for the Treatment of Phantom Limb Pain in Amputees: A Pilot Study
- Author
-
Michael J. Miller, David K. Monson, Charles A. Gilliland, C. Matthew Hawkins, Jackie Knight, Paul Harkey, J. David Prologo, Darren D. Kies, Luke P. Brewster, David Corn, Faramarz Edalat, and Sean R. Dariushnia
- Subjects
Adult ,Male ,medicine.medical_specialty ,Percutaneous ,Georgia ,Time Factors ,Visual analogue scale ,medicine.medical_treatment ,Pilot Projects ,Cryosurgery ,Article ,law.invention ,03 medical and health sciences ,Disability Evaluation ,0302 clinical medicine ,Randomized controlled trial ,Amputees ,030202 anesthesiology ,law ,Surveys and Questionnaires ,Peripheral Nervous System ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,Cryoneurolysis ,Aged ,Pain Measurement ,Ultrasonography ,Aged, 80 and over ,business.industry ,Cryoablation ,Pain Perception ,Middle Aged ,Denervation ,Surgery ,Clinical trial ,Treatment Outcome ,Phantom Limb ,Roland Morris Disability Questionnaire ,Feasibility Studies ,Female ,Cardiology and Cardiovascular Medicine ,business ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery - Abstract
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.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.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).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.
- Published
- 2016