Cryosurgery
Minimally invasive, pain relief procedures.
Cryoanalgesia is a well studied and specialized technique for providing long-term pain relief for various foot and ankle conditions. The value of cold for anesthesia and pain relief has been recognized for thousands of years. The technique of cryo-neuroablation is superior to other methods of peripheral nerve destruction (e.g. alcohol injections, phenol applications, or surgical resection) because it is not followed by subsequent neuritis or neuralgia. The application of cold to a nerve creates a nerve conduction block. This is similar to the effect of local anesthetics, but the effect is long lasting. Long-term pain relief from nerve freezing occurs because the formation of an ice crystal formation disrupts the sensory transmission pathway of the nerve structure.
CRYOSTAR TECHNOLOGY
Cryogenic Technology, LTD originally developed the Cryostar system. Over the past 5 years, its use for podiatric-related conditions has been extensively tested for safe, effective and proven pain relief. The Cryostar was FDA approved for use in podiatric ailments in June 2003. We use the newer generation Cryopac Plus, distributed by Cryotech LLC, equipment in our office. The CryoPac Plus has the benefit of increased portability and comes equipped with all of the features of the original CryoPac plus the neuro-Stimulation function. The addition of the neuro-stimulation feature extends the range of treatments to include applications where the precise location of the target nerve is essential to the positive outcome of the treatment.
NEUROMAS AND PLANTAR FASCITIS
Morton’s neuroma is a common podiatric condition we frequently see in our office. Symptoms present as pain commonly between the send and third or third and fourth metatarsals that causes numbness, tingling, burning, or shooting pains on the ball of the foot and into the involved toes. Patients often report the sensation of an electric shock in the ball of the foot. Poorly fitting shoes appears to worsen the symptoms. Standard treatments such as cortisone injections and surgery have fair to good results. The CryoPac Plus is a more effective treatment option for these painful nerve conditions. It has also proven effective for patients who have undergone previous a surgical treatment with recurrence of the “stump” neuroma.
The most common ailments we see in our practice are plantar fasciitis, heel spurs, and other heel pain syndromes. Current treatments we employ are: cortisone injections, strappings, orthotics, oral anti-inflammatories, manual therapy, and relative rest. All of these have had fair to good success when treatment protocols are observed. Pain relief can take weeks to months to come. Some newer surgical procedures such as endoscopic plantar fasciotomies (EPF) and shock wave therapy (ESWT) have shown us fair results. The Cryostar technology has been able to achieve results equal or better than all these surgical procedures, and at a much lower cost to the patient.
OTHER INDICATIONS FOR CRYOSURGERY
We recognize that the CryoPac Plus can be used to treat many other foot problems. Nerve compression disorders in other parts of the foot such as Tarsal Tunnel Syndrome and sural, calcaneal, and peroneal nerve entrapments can be treated effectively with the CryoPac Plus. Management of diabetic peripheral neuropathy and painful osteoarthritis has shown promising results. Soft tissue tumors, painful scars, and other painful skin conditions are also effectively managed with this technology.
THE PROCEDURE
Cryosurgery is performed in the offices of Drs. Kevin Murray and Stewart Chang. This minimally invasive technique takes 15 minutes to perform. The skin over the painful area is infiltrated with a local anesthetic. A tiny puncture is made through the skin. Next, the Cryoprobe Is introduced through the puncture site, the probe is positioned over the affected nerve or area of maximal tenderness, and the CryoPac Plus is place through a pre-determined freeze-defrost-freeze. Pain relief is accomplished by applying extremely cold temperatures of -50° to -70°C. A 5.5 mm ice ball forms at the probe tip. This ice ball causes freezing of the nerve trunk resulting in reduction of pain transmission. The probe is then removed. An antibiotic ointment is placed over the puncture site with a sterile dressing applied. Stitches are not necessary. The dressing maybe removed within 24. The puncture site is to be covered with a small amount of antibiotic ointment and a band-aid until healed. It is suggested that you decrease your normal level of activity over the first 48 hours. Your next scheduled visit will be in 3-7 days.
INSURANCE COVERAGE
Most insurance plans we participate with in this office indicate that they provide coverage for this procedure. It is your ultimate responsibility to check with your insurance carrier for specific coverage exclusions or limitations. For insurance plans that we do not participate with or where coverage is not provided, payment will be expected on the day that services are rendered.
SCHEDULING
Call today for your evaluation and consultation appointment. We will advise if Cryosurgery is the right option for your circumstances.
ARTICLES
http://www.cryotech-int.com/Articles/Default.htm
http://www.podiatrytoday.com/article/6578