300 Section - Cryoneurolysis as a treatment for spasticity in patients with spinal cord injury; A retrospective comparison of patient outcomes across targeted nerves.

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

HP

Hendrik L. Pepler, BS

Medical Student
University of British Columbia
Victoria, British Columbia, Canada

Co-Author/Coautor(s)

Mahdis Hashemi, MD

Researcher
Vancouver Island Health Authority
Victoria, British Columbia, Canada

Corresponding Author/Autor a quien dirigir la corr(s)

Paul J. Winston, MD

Physiatrist and Researcher
Vancouver Island Health Authority
Victoria, British Columbia, Canada

Objectives : Spasticity from spinal cord injury (SCI) can impair joint range of motion (ROM) and cause pain, affecting function and quality of life. While many approaches to managing spasticity exist, there is limited research on cryoneurolysis for managing spasticity in SCI patients.

Objective:
To evaluate the effect of cryoneurolysis on shoulder and ankle ROM and muscle tone in adults with SCI.

Design: This single-center retrospective chart review assessed maximum passive ROM using a goniometer and muscle tone using the Modified Ashworth Scale (MAS) as primary outcomes. Shoulder ROM was evaluated for abduction, flexion, and external rotation, while ankle dorsiflexion was measured with the knee in both flexed and extended positions. Pre- and post-treatment values were compared using paired t-tests.

Results: At an average of 62 days post-treatment, significant improvements in shoulder ROM were observed: abduction increased by 21.0° (P< 0.001, n=9), and flexion by 15.0° (P=0.0017, n=9). Shoulder external rotation improved by 10°, though this was non-significant. Shoulder flexion gains remained significant at second follow-up (16.0°; P=0.0050, n=9) at about 168 days post-treatment. Tone (MAS) in shoulder flexion and abduction showed significant reductions by 1 point between baseline and first follow-up (P=0.0032, n =9; P=0.013, n=8), which was maintained at second follow-up (P=0.0057, n=9; P=0.017, n=8). Tone in shoulder external rotation had a non-significant decrease by 1 point. At an average of 89 days post-treatment, significant improvements in ankle dorsiflexion ROM were observed: dorsiflexion with the knee in extension increased by 5.0° (P=0.026, n=12) and dorsiflexion with the knee in flexion increased by 6.0° (P=0.018, n=12). Tone during dorsiflexion with the knee flexed decreased significantly by 1.0 point (P=0.009, n=12).

Conclusion: Cryoneurolysis significantly improves shoulder and ankle ROM and tone in SCI patients, supporting its potential as an alternative treatment for focal spasticity. Further studies with larger samples and extended follow-up are warranted.