NerveBlocksandNeurolysis

J.DavidPrologo,MD

DisclosuresJ.DavidPrologo:Consultant– BTG,MeritMedical;Grant/ResearchSupport– BTG,Healthtronics

Brandnamesareincludedinthispresentationforparticipantclarificationpurposesonly.Noproductpromotionshouldbeinferred.

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Complex “Blocks” (Cryoneurolysis)

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Temperature Mediated Injury to Nerves+10⁰ C

Temporary

signaling

inactivation

-20⁰ C

Axonotmesis

-5⁰ C

Conduction

block lasting

hours - days

Na/K pump

disruption

Axonal and myelin degeneration

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Nerve Injury

Ilfeld BM, et al. Expert Rev Med Devices. 2016;13(8):713-725.

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Nerve Injury

Trescot AM. Pain Physician. 2003;6(3):345-360.

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L4 Radiculopathy

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VIP Story

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Inpatients

N = 12

∆ VAS = 5.2 (p<0.0001)

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S1

67-year-old male with

intractable right S1

radiculopathy. Pt has metastatic

renal cell carcinoma and a

known sacral lesion, which has

been radiated twice.

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Don’t stab the nerve

8-10, 3, 8-10, 3 if possible

First 24 hours

Manage expectations

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Division of Interventional Radiology andImage-guided Medicine

Emory University Hospital, Emory University Hospital Midtown,Children’s at Egleston, Grady Memorial Hospital, Emory Saint Josephs and Emory Johnscreek

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Division of Interventional Radiology andImage-guided Medicine

Emory University Hospital, Emory University Hospital Midtown,Children’s at Egleston, Grady Memorial Hospital, Emory Saint Josephs and Emory Johnscreek

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L5

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T11

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Is This New?

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Questions?