525 - Outcomes Following Ultrasound-Guided Percutaneous Cryoneurolysis for the Treatment of Spasticity

Design: Retrospective chart review

Setting: Neurorehabilitation Outpatient Clinic

Participants: Twenty-four patients who underwent cryoneurolysis for treatment of pain associated with spasticity from February 2024 to June 2025 were reviewed

Interventions: All patients (n=24) underwent a diagnostic lidocaine injection and subsequent cryoneurolysis of upper and/or lower extremity nerves.

Main Outcome Measures:
Baseline and follow-up ( >3 months) spasticity assessed with the Modified Ashworth Scale (MAS).
Patient-reported outcomes documented >3 months after cryoneurolysis, including changes in function, pain or side effects.

Results:

Baseline and follow-up MAS was available for 19 patients and showed statistically significant improvement from a median baseline of 3 (IQR 1.5) to follow-up of 1+ (IQR 1; W = 7, P < 0.05). Timed Up & Go (TUGs) assessments were available for five patients and did not reveal a significant difference post-intervention (baseline TUG 31s vs s/p cryoneurolysis 20s, p=0.14). Subjective functional improvements were reported in 18 patients (94%, n=21) and pain relief was noted in 16 patients (81%) at follow-ups. Side effects included pain, dysesthesias, and weakness.  

Conclusions:

Ultrasound-guided percutaneous cryoneurolysis is an emerging and innovative intervention that has shown promise in the treatment of spasticity. In this study, patients achieved significant improvements in MAS three months post-intervention along with subjective improvements in function and pain with minimal side effects. Cryoneurolysis may provide a promising adjuvant treatment for spasticity or alternative for cases refractory to current standard of care.