Interventional procedure overview of percutaneous image-guided cryoablation of peripheral neuroma for chronic pain
Closed for comments This consultation ended on at Request commenting lead permission
Appendix
The following table outlines the studies that are considered potentially relevant to the IP overview but were not included in the summary of the key evidence. It is by no means an exhaustive list of potentially relevant studies.
Article | Number of patients/ follow up | Direction of conclusions | Reasons for non-inclusion in summary of key evidence section |
|---|---|---|---|
Bittman RW, Behbahani K, Gonzalez F et al. (2019) Interventional cryoneurolysis: what is the same, what is different, what is new? Seminars in Interventional Radiology 36: 374–80 | Review | The integration of interventional radiology to the longstanding clinical concept of applying cold temperatures to nerves has illuminated several new procedural options and potential applications for the therapy. | Relevant cited papers have been included in the key evidence. |
Bittman RW, Peters GL, Newsome JM et al. (2018) Percutaneous image-guided cryoneurolysis. AJR. American Journal of Roentgenology vol. 210: 454–65 | Review | Percutaneous image-guided cryoneurolysis is safe and effective for the management of several well-described syndromes involving neuropathic pain. Additional rigorous prospective study is warranted to further define the efficacy and specific role of these interventions. | Relevant cited papers have been included in the key evidence or appendix. |
Djebbar S, Rossi IM, Adler RS (2016) Ultrasound-guided cryoanalgesia of peripheral nerve lesions. Seminars in Musculoskeletal Radiology 20: 461–71 | Review | Ultrasound enables a continuous monitoring of adjacent soft tissue structures while the cryoprobe is active, minimising collateral damage. Cryoablation of painful peripheral nerve lesions is a safe alternative to other ablative techniques to achieve long-term analgesia. | Descriptive review with some outcome data on patients with a variety of nerve lesions. |
Filippiadis D, Efthymiou E, Tsochatzis A et al. (2021) Percutaneous cryoanalgesia for pain palliation: Current status and future trends. Diagnostic and Interventional Imaging 102: 273–8 | Review | Percutaneous cryoanalgesia under imaging guidance can be considered demonstrably effective at treating pain of both neo-plastic and non-neoplastic substrate. Imaging guidance and ability to visualise ice ball adds to safety and efficacy. | Relevant cited papers have been included in the key evidence or appendix. |
Matthews BG, Hurn SE, Harding MP et al. (2019) The effectiveness of non-surgical interventions for common plantar digital compressive neuropathy (Morton's neuroma): a systematic review and meta-analysis. Journal of Foot and Ankle Research 12: 12 | Systematic review (8 interventions) n=1,974 (25 studies) | Corticosteroid injections and manipulation or mobilisation are the 2 interventions with the strongest evidence for pain reduction, however high-quality evidence for a gold standard intervention was not found. Although the evidence base is expanding, further high quality RCTs are needed. Two case series of cryoneurolysis showed a weighted success rate of 75% (95% CI 54 to 92%) but studies were described as low quality. | Only 2 studies on cryoablation were included, both of which are described in the key evidence. |
Ramsook RR, Spinner D (2017) Ultrasound-guided cryoablation of a traumatic hip disarticulation neuroma. Pain practice: the official journal of World Institute of Pain 17: 941–4 | Case report n=1 | Ultrasound-guided cryoablation of a traumatic hip disarticulation neuroma resulted in complete pain relief and improved functionality and independence. | Case report |
Rhame, Ellen E; Debonet, Alexander F; Simopoulos, Thomas T (2011) Ultrasonographic guidance and characterization of cryoanalgesic lesions in treating a case of refractory sural neuroma. Case Reports in Anesthesiology 2011: 691478-691478 | Case report n=1 | Cryoanalgesia in conjunction with ultrasound guidance was used successfully to manage recurrent pain of a neuroma following surgical excision and burial of nerve endings. Ultrasound provided visualisation of the cryolesions, as well as the relationships of the ice ball to the surrounding tissue. | Case report |
Thomson L, Aujla RS, Divall P et al. (2020) Non-surgical treatments for Morton's neuroma: A systematic review. Foot and Ankle Surgery 26: 736–43 | Systematic review 22 studies | Following review, the authors would recommend the use of corticosteroid injections to treat Morton's neuromas. The authors feel that radiofrequency ablation and cryoablation would benefit from further well designed randomised controlled trials. | Only 1 study on cryoablation was included, which did not use image guidance. |
How are you taking part in this consultation?
You will not be able to change how you comment later.
You must be signed in to answer questions