900 Section - Service Evaluation of Cryoneurolysis for Spasticity in a Single Centre: Safety, Effectiveness, and Clinical Practice

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

AM

Aoife Murray, MD

Specialist Registrar
Oxford Centre for Enablement, Oxford University Hospital Trust
Galway, Galway, Ireland

Co-Author/Coautor(s)

TH

Tom Hatfield, MD

Medical Student
Oxford University
Oxford, England, United Kingdom
RD

Rachel Dye, n/a

Highly Skilled Physiotherapist
Oxford Centre for Enablement
Oxford, England, United Kingdom
AP

Anton Pick, MD

Consultant in Rehabilitation Medicine
Oxford Centre for Enablement
Oxford, England, United Kingdom

Objectives : Cryoneurolysis can be used in spasticity management to reduce focal muscle overactivity and improve functional outcomes. The Oxford Spasticity Service is the first in the UK to implement a dedicated cryoneurolysis pathway incorporating diagnostic nerve blocks, multidisciplinary assessment, procedural intervention, and structured follow-up. This service evaluation aimed to assess the safety and effectiveness of the Oxford Cryoneurolysis Clinics during their first year of operation (December2023 to January2025), focusing on referral pathways, procedural standards, complication rates, documentation, and treatment goal attainment.

Design: A retrospective service evaluation was conducted on all patients who underwent cryoneurolysis during the evaluation period. Data were collected from clinical documentation, referral records, procedural notes, and follow-up assessments. Twenty-eight patients underwent 42 cryoneurolysis procedures during the study period; one patient was excluded in follow up data due to unrelated death. All patients received diagnostic nerve blocks and goal setting prior to intervention. Procedures were performed under ultrasound guidance with electrical stimulation for nerve localisation. Adverse events, documentation quality, post-procedural pain, and Global Assessment of Benefit goal attainment were reviewed.

Results: Of 42 procedures, 71% of patients experienced at least one peri-procedural effect, most commonly pain (n=17), followed by sensory disturbance (n=3), pre-syncopal symptoms (n=2), minimal bruising (n=1), and non-targeted motor weakness (n=1). These were transient and self-limiting. Post-procedure pain occurred in 56% (n=15), with 14.8% (n=4) experiencing pain lasting beyond one month. Documentation of specific post-procedure pain advice was present in 19 of 28 cases. Treatment goals were achieved in 85% (23 of 27) of patients. Repeat cryoneurolysis was performed in 43% (n=12).

Conclusion: The Oxford Cryoneurolysis Service demonstrates safe and effective practice in its first year, with high goal attainment and predictable side-effect profiles. Standardising post-procedure advice, peri-procedural pain management, and follow-up documentation would further improve patient experience. Ongoing evaluation will assess long-term outcomes and inform optimal patient care.