Cryoneurolysis for spasticity, associated pain and presumed contracture.

Session outline

Cryoneurolysis is a revolutionary new method to treat spasticity via a drug free percutaneous treatment that offers long lasting surgical like results. Cryoneurolysis is the first major advancement in spasticity care in decades and is growing rapidly from it’s nascence in Canada. We will outline the novel idea of pre-screening with ultrasound guided nerve blocks.  Due to its wide application on nerves, cryoneurolysis can reduce spasticity, increase range of motion and treat pain, and has shown significant improvement in the patient who has plateaued on other treatments.  Cryoneurolysis offers the developing world a far more accessible long lasting treatment due to huge cost savings over traditional medical therapies.

We will offer a comprehensive package, teaching the science, clinical cases, review the evidence and a live ultrasound guided hour long demonstration on how to target nerves. We welcome a group from the general public and advocacy groups for the didactic portion and to watch the ultrasound courses to allow the public to see the potential to regain function, reduce pain and introduce greater patient independence and autonomy. The foundation of cryoneurolysis for spasticity is patient and care giver identified goals.  We will underscore that our treatment paradigm is heavily based on an indigenous model of informed consent and patient prediction of what the future will look like, through pre-treatment diagnostic nerve blocks.

1. Introduction to cryoneurolysis with the mechanism of action- Dr. Eve Boissonnault, Canada
2. Colourful and clear clinical case examples demonstrating how to target a motor nerve, sensory nerve, mixed motor sensory trunk or intramuscular nerve branch.
3. Pediatric targeting and considerations for treatment.
4. Review of the rapidly emerging literature from 2019 to the present, including analysis of side effects. This will highlight the evidenced based methodology that underscores cryoneurolysis.
5. Clinical care choices, multiple case examples where the audience gets to choose which nerves they would target for each spastic pattern.
6. A one and half hour ultrasound workshop with our four faculty members. This will focus on how to find and target the entire upper and lower extremity to localize the proper nerves.  Then a dedication explanation on how to offer cryoneurolysis to each nerve.

Learning outcomes

1. A deep understanding of the idea that contractures are not absolute. That many patient actually have reducible deformities that can be overcome with nerve targeted procedures.
2. A solid base in the physics of freezing nerves at -88C Celsius to offer long lasting results.
3. A colourful understanding of which patients are the optimal Candidates for cryoneurolysis.
4. A novel approach to offer an alternative to surgery in children.
5. An appreciation of the massive health systems savings with this treatment over the more common treatments.
6. Appreciate that patient led outcomes can lead to successful outcomes, though the use of true informed consent.

Target audience

We encourage all backgrounds to attend.

• Allied health
• Medical practitioners
• Students
• Trainees
• Nursing staff
• General public