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

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.