Abstract No. 143: Percutaneous Image-Guided Induction of Neuroregeneration as a Repair Mechanism for Damaged Nerves
Researchers at Emory University are investigating a novel regenerative approach to treat chronic nerve pain, for which effective long-term treatments are currently lacking.
For patients with chronic nerve pain, there are no established gold standard medication combinations or procedures that provide long-term relief, said J. David Prologo, MD, FSIR, and Maxwell E. Cooper, MD, authors of Percutaneous Image-Guided Induction of Neuroregeneration as a Repair Mechanism for Damaged Nerves, one of the SIR 2025 Featured Abstracts.
Because up to 10% of the population is afflicted with chronic neuropathic pain, and existing treatments are often suboptimal, a substantial patient population may feel medically abandoned and at risk for opiate addiction.
“In our practice we have seen thousands of patients who have had their nerves damaged by surgery or trauma, whose doctors have given them a medication that didn't work and then told them there wasn't anything else to do,” said Dr. Prologo.
Inspired by these patients, Dr. Prologo and his team set out to investigate a way to induce correction of the damage in an injured or irritated nerve by essentially replacing the damaged nerve with a new one that doesn’t send pain signals.
According to researchers, both animal and human studies have shown that controlled exposure to cold temperatures could trigger nerve changes leading to regeneration. This led to the hypothesis that inducing these events could effectively allow physicians to replace hyperirritable, symptomatic nerves.
The abstract details the experiences of five patients who underwent percutaneous neuroregenerative therapy during a 7-year period. All patients demonstrated clinical signs of neural regeneration at follow-up, and three of the five reported pain resolution within a year.
For Dr. Prologo, the ability to provide patients with an option that was currently unavailable is incredibly important.
“The first story of this procedure being done is quite inspirational,” he said. “A young woman approached our practice after having a pelvic nerve stretched and damaged during childbirth. She had constant debilitating pain for which she was told nothing could be done—or she could take medications that made her drowsy or high,” he said. “We performed CT-guided pudendal nerve cryoablation and replaced her damaged nerve with a new nerve. She returned to her life and raised her child.”
Dr. Prologo says his team has many inspirational stories like this and is eager for patients to learn that there is an option for them, one that can be done with just a needle and image guidance, and no long-term medications.
“Up to 10% of the human population—more than 700 million people—are affected with chronic nerve pain. The ability to induce a process that would essentially wipe away the damaged portions of the nerve and replace them with normal nerve tissue could have incredibly wide-reaching effects,” he said. “What's more, there is no other such regenerative therapy for nerves currently available.”
The next step, Dr. Prologo believes, is disseminating this knowledge and encouraging other IRs to adopt the procedure, as well as making it clear to patients that he, his team and other IRs deeply care about their pain.
“We care about them. We understand that they have been abandoned because there haven’t been good options for them,” he said. Even if a patient isn’t a candidate for the procedure, he encourages IRs to still take them in and provide the advocacy they would to their own family members.
Dr. Prologo and Dr. Cooper will present their findings at SIR 2025 on Monday, March 31, at 3 p.m. during the Pain Management 1 session.
