Cryoneurolysis as a Neuroregenerative Intervention for Chronic Painful Mononeuropathies: A Four-Patient Case Series and Discussion.

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.