2025 American Academy of Neurology Abstract Website

Objective:

The aim of this systematic review is to evaluate the effectiveness of cryoneurolysis intervention in the management of phantom limb pain.

Background:

Phantom limb pain (PLP) is a painful sensation occurring in patients around the site of an amputation that can significantly reduce a patient's quality of life. The aim of this systematic review is to evaluate the effectiveness of cryoneurolysis intervention in the management of phantom limb pain.

Design/Methods:

A systematic review was performed following PRISMA 2020 guidelines. An initial search yielded 200 articles from the following databases: PubMed, Embase, Cochrane Library, and WebOfScience. 5 articles met inclusion criteria, 4 of which underwent additional pooled statistical analysis.

Results:

Pooled analysis of the four included trials revealed a cumulative Cohen's d effect size of 1.55 (95% CI: 0.24, 2.87; p = 0.02; z = 2.32) for the reduction of pain on a 10-point pain scale following cryoneurolysis intervention. The remaining article that did not meet inclusion criteria for statistical analysis was a case report that reported reduction in pain from 9/10 to 1/10 one week following intervention.

Conclusions:

The large effect size demonstrated a statistically and clinically significant improvement in patient-reported pain. Additionally, patients may be able to reduce their amount of pharmaceutical pain management with successful cryoneurolysis treatment. However, these findings are limited by small sample size and high heterogeneity between studies. Cryoneurolysis yielded significant decreases in patient-reported pain in patients suffering from phantom limb pain. The results are promising, and further studies should be performed.