The present invention generally relates to improved medical devices, systems, and methods. In many embodiments, devices, systems, and methods for amputating a limb of a patient are provided. In many embodiments, devices, systems, and methods may provide chronic denervation of one or more nerves of a patient as part of a therapeutic treatment. The methods may employ cold for the prevention of neuromas or fibromas associated with amputation of a limb of a patient. Embodiments of the invention include needles that can be advanced through skin or other tissues to cause axonotmesis of a target nerve of the patient and to repeatedly interrupt a regeneration of the nerve so as to provide therapeutic chronic denervation of the target nerve. The therapeutic chronic denervation may delay the formation of neuromas or fibromas in a patient's residual limb and/or may provide long lasting and permanent pain relief associated with the target nerve.