Evaluating the Predictive Value of Pre-procedural Diagnostic Nerve Blocks in Patients Undergoing Cryoneurolysis.

Authors

Shamar Young, Ahmet Gunkan, Sarah Placek, Lucas Struycken, Artyom Abramyan, Ilaria Vittoria De Martini, Jack Hannallah, Gregory Woodhead, Daniel Goldberg

Published in

Cardiovascular and interventional radiology. Jul 29, 2026. Epub Jul 29, 2026.

Abstract

To evaluate the impact of pre-cryoneurolysis blocks by comparing outcomes between patients who underwent cryoneurolysis without a pretreatment block and those who underwent cryoneurolysis following a diagnostic block.
A retrospective single-center analysis was performed of patients who underwent CT-guided cryoneurolysis for intractable abdominopelvic pain. Patients were categorized according to whether a pre-cryoneurolysis diagnostic block was performed. Clinical success was defined as an improvement in Visual Analog Scale (VAS) pain score of ≥ 3 points. Pre- and post-procedural pain scores and adverse events (AEs) were assessed.
For entire cohort, including 52 patients who received a pre-cryoneurolysis block and 43 patients who did not, mean VAS score improved from 8.4 ± 1.6 pre-procedurally to 3.9 ± 2.5 at 1 week (p < 0.001), 3.8 ± 2.7 at 1 month (p < 0.001), and 4.8 ± 3.2 at 3 months (p < 0.001) after cryoneurolysis. Use of a pre-cryoneurolysis-block was associated with a mean delay of 16.1 ± 13.5 days (range, 0-50) to cryoneurolysis. Clinical success rates did not differ significantly between the block and non-block groups at 1 week (76.6% [36/47] vs 78.4% [29/37], p = 1.0), 1 month (81.1% [30/37] vs 69.7% [23/33], p = 0.403), or 3 months (62.5% [15/24] vs 75.0% [15/20], p = 0.519). No AEs were observed.
CT-guided cryoneurolysis provides significant pain relief for cancer- and non-cancer-related chronic abdominopelvic pain, with comparable pain improvement regardless of whether a pre-cryoneurolysis diagnostic block is performed. When the pain source is clearly identified, direct cryoneurolysis may be a reasonable option.

PMID:
42527618
Bibliographic data and abstract were imported from PubMed on 30 Jul 2026.

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