Cryoanalgesia
Long-lasting analgesia can be achieved by exposing cold on peripheral nerves. The development of special cryoprobes, has enabled the targeted application of the cold effect to a peripheral nerve associated with the pain. In the process, use is made of the Joule-Thomson effect by which gases expand and cool off when released through a small opening.
The basic principle consists in the precise localisation of the affected nerve under visual control and electrical stimulation. This is followed by two-minute icing at about -65 °C. The freezing causes axonotmesis, i.e., severing of the axon and damage to the myelin sheath whereby the sheath structure of the nerve remains intact and enables the regeneration of the nerve. The nerve remains numb for a few months or longer but is not destroyed.
The main indications are treatment-resistant, chronic pain in the spinal area and most commonly the lumbar facet syndrome.
- spinal facet syndrome
- pseudoradicular postnucleotomy syndrome (radiating pain after intervertebral disc surgery)
- discogenic pain without prolapsed intervertebral disc (nucleus pulposus prolapse)
- coccygodynia (coccyx or tailbone pain)
- post-thoracotomy pain
- primary and secondary intercostal neuralgia
- neuroma pain syndromes