Cryoneurolysis and Quadriplegia: A Case Report on Pain and Severe Spasticity Management
Bibliographic record
Abstract
Spasticity, a common symptom after spinal cord injury, often leads to pain, muscle contracture, and compromised daily activities. Cryoneurolysis, a minimally invasive, drug-free procedure for the treatment of pain, is now gaining recognition for treating spasticity. It involves using an ultrasound-guided probe to freeze and destroy overactive target nerves. The objective of this case study was to assess the effect of cryoneurolysis on joint range of motion (ROM) by reducing spasticity and pain in a person with quadriparesis spinal cord injury. A 52-year-old male with C4 incomplete quadriplegia presented with severe right hip osteoarthritis, causing a severe hip flexion deformity with hip flexor spasms, as well as spasticity in the upper limbs. Previous attempts with exceeding maximum-dose botulinum toxin injections for the lower limb proved insufficient to improve ROM. Percutaneous cryoneurolysis was performed on multiple nerves, contributing to spasticity in the upper and lower limbs. Immediately after each procedure, the patient experienced an increased ROM in the upper and lower limb targeted regions. During the patient's follow-up, he also reported improvements in performing daily activities, such as independent showering, no falls, and a significant decrease in muscle tone. Results were primarily maintained up to 9 months postprocedure when cryoneurolysis was repeated for the lower limbs only. On repeat cryoneurolysis, results were re-established. Cryoneurolysis is a nonsurgical, percutaneous procedure that could be considered for pain and spasticity management in patients with quadriplegia. It can provide an option for improved quality of life and independence for patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".