At Myoscience, we support healthcare providers who use our innovative products and technology by providing them all the resources they need to effectively incorporate the ioverao technology into their practice.

Our comprehensive package includes training for physicians and staff on the technology, back office support with coding and billing guidelines, and ensuring customer satisfaction with regular follow-ups.

We are confident that our technology will ensure patient satisfaction.  We want to ensure provider (customer) satisfaction by working inconspicuously with the back office.  Our support team includes Clinical Account Managers, Product Support Specialists and Reimbursement Specialists, who work 15 hours a day to ensure all our customers’ needs are met irrespective of which time zone they are in.

History of Cryoanalgesia

Cold has been used to relieve pain since the days of Hippocrates in ancient Greece. Modern cold therapy, or cryoanalgesia, has been around since the 1950s and is a trusted technology for treating pain.

The ioverao system has revolutionized the delivery of cryoanalgesia. Until now, traditional cryoanalgesia treatments were invasive and used large complicated machines. With the ioverao system, doctors are able to deliver precise, controlled doses of cold through a portable, handheld device. This minimally invasive treatment is safe, and causes no damage to surrounding tissues.1

Cryoanalgesia with the iovera° system

To understand how cryoanalgesia (also known as cryoneurolysis) is achieved with the ioverao system, it is important to first understand the varying degrees of nerve injury and the temperatures at which they occur.  Sunderland described and classified the basic types of nerve injuries to assist in the prognosis and treatment strategy for these injuries.2,3

Sunderland Nerve Injury Classification

Reversible

1st Degree

Neuropraxia – interruption of conduction; Short recovery time (ice pack)
+10oC to -10oC

2nd Degree

Axonotmesis – loss of continuity of the axon; Wallerian degeneration; preservation of endo- peri- and epineurium (carbon dioxide, nitrous oxide)

-10oC to -100oC
ioverao therapy: -88oC

Irreversible

3rd and 4th Degree

Neurotmesis – loss of continuity; some loss of continuity of epineurium and perineurium; endoneurium may or may not be disrupted (liquid nitrogen, liquid argon)

Colder than -100oC
not possible with the ioverao system

5th Degree

Transection (Severe Neurotmesis) – Gross loss of continuity

not possible with the 
ioverao system

Sunderland Nerve Injury Classification

Reversible

1st Degree (+10°C to -10°C)

Neuropraxia – interruption of conduction; Short recovery time (ice pack)

2nd Degree (-10°C to -100°C)

Axonotmesis – loss of continuity of the axon; Wallerian degeneration; preservation of endo- peri- and epineurium (carbon dioxide, nitrous oxide); ioverao therapy: -88oC

Irreversible

3rd and 4th Degree (colder than -100°C)

Neurotmesis – loss of continuity; some loss of continuity of epineurium and perineurium; endoneurium may or may not be disrupted (liquid nitrogen, liquid argon); not possible with the ioverao system

5th Degree

Transection (Severe Neurotmesis) – Gross loss of continuity; not possible with the ioverao system

Axonotmesis involves loss of the relative continuity of the axon and its covering of myelin, but preserves the connective structure of the nerve (the endoneurium, epineurium and perineurium).

Other characteristics:

  • Wallerian degeneration occurs distal to the site of injury.
  • When axonotmesis affects a sensory nerve, the sensory deficits occur distal to the site of lesion.
  • Axonal regeneration occurs at a rate of 1-2mm per day4, after which sensory signalling is restored.

Mechanism of Action

  1. Hsu, M. and F.F. Stevenson, Wallerian degeneration and recovery of motor nerves after multiple focused cold therapies. Muscle & Nerve, 2015. 51(2): p. 268-275.
  2. Sunderland, S., A classification of peripheral nerve injuries producing loss of function. Brain, 1951. 74(4): p. 491-516.
  3. Sunderland, S., Nerves and nerve injuries. 1968, Edinburgh & London: Livingstone.
  4. Evans, P.J., Cryoanalgesia. The application of low temperatures to nerves to produce anaesthesia or analgesia. Anaesthesia, 1981. 36(11): p. 1003-13.