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Neurological Rehabilitation

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

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Kiosk 10

    Primary Author(s)

  • Colette Piasecki-Masters, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Boston, Massachusetts

    • Co-Author(s)

  • HR

    Hye Chang Rhim, MD

    Sports Medicine Fellow
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

  • JR

    Joseph Ruiz, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Somerville, Massachusetts

  • RG

    Rebecca Greenspan, DO

    Faculty
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Boston, Massachusetts

  • RJ

    Rafael T. Jimenez, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    San Luis Obispo, California

  • Raymond Guo, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Plano, Texas

  • Jennifer Su, MD (she/her/hers)

    Resident Physician
    Spaulding Rehabilitation Hospital/Harvard Medical School
    Boston, Massachusetts

  • Dylan B. Combs, MD

    Resident Physician
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

  • Craig Rovito, MD

    Program director
    Spaulding Rehabilitation Hospital
    Charlestown, Massachusetts

Disclosure(s):
Colette Piasecki-Masters, MD: No financial relationships to disclose
Joseph Ruiz, MD: No financial relationships to disclose
Raymond Guo, MD: No financial relationships to disclose
Dylan B. Combs, MD: No financial relationships to disclose
Background and/or Objectives: To review the 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 March 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 11 patients and showed statistically significant improvement from baseline of 2.5 (± 0.42) to follow-up of 1.5 (± 0.46; P < 0.001). 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 17 patients (88%) and pain relief was noted in 14 patients (64%) 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.