# Intercostal Cryoneurolysis for Chest Wall Pain in Patients With Vertebral Osteomyelitis

## TL;DR

This paper presents a case where intercostal cryoneurolysis was used to treat chest wall pain caused by vertebral osteomyelitis.

## Contribution

The paper introduces the use of intercostal cryoneurolysis for infection-related chest wall pain, which is rarely discussed.

## Key findings

- A 53-year-old patient with vertebral osteomyelitis experienced chronic chest wall pain.
- The patient underwent ultrasound-guided nerve block and CT-guided cryoneurolysis as an alternative to long-term medication.
- The case highlights procedural techniques and potential complications of cryoneurolysis for this condition.

## Abstract

Intercostal cryoneurolysis (IC) is an image-guided technique that provides prolonged analgesia through targeted cold-induced axonal degeneration. While it is most commonly used for post-traumatic, postoperative, and malignancy-related chest wall pain, its role in infection-associated pain syndromes remains poorly described. We report the case of a 53-year-old man with a history of vertebral osteomyelitis complicated by abscess formation who developed chronic right-sided dermatomal chest wall pain and sought an alternative to long-term pharmacologic therapy. The patient initially underwent an ultrasound-guided diagnostic intercostal nerve block, followed by computed tomography-guided IC. This report discusses patient selection, procedural technique, and potential complications associated with IC for intractable chest wall pain.