1000 Section - Cryoneurolysis for Phantom Limb Pain: A PRISMA-ScR–Formatted Scoping Review

Eligibility criteria: Relevant human studies and reviews were identified before conducting the analysis; English; any design focused on cryoneurolysis/cryoablation of peripheral nerves for perioperative amputation analgesia or established PLP.

Sources of evidence: PubMed, Scopus, Cochrane, Web of Science, CINHAL, and Embase; all items accessed between April to September 2025.

Charting methods: Single-reviewer screening and data charting of design, population, targets/timing, parameters, outcomes (pain/PLP), follow-up, and safety; no formal critical appraisal (per PRISMA-ScR).

Results:

Results: Thirteen sources were included. For established PLP, small uncontrolled studies and an interventional radiology pilot suggest clinically meaningful relief when a peripheral generator is identified; a PLP-focused systematic review pooled four studies demonstrating large effect size for pain reduction, suggestive of clinically meaningful improvement; For perioperative prevention, case-level signals are favorable, but a randomized, masked pilot found no superiority over sham for chronic PLP at ~4 months under its protocol. Serious adverse events were uncommon across reports.

Conclusion:

Conclusions: Cryoneurolysis is feasible and appears effective for selected patients with established PLP when a peripheral nociceptive focus is confirmed; routine perioperative use to prevent PLP remains unproven. Prioritized research needs: standardized targeting/freezing parameters, comparative trials (vs TMR/RPNI/PNS), and patient-anchored outcome thresholds.