Clinical efficacy of MVD combined with PSR in the treatment of primary trigeminal neuralgia

Abstract

Clinical efficacy of microvascular decompression (MVD) combined with percutaneous stereotactic radiofrequency rhizotomy (PSR) in the treatment of primary trigeminal neuralgia was investigated. The medical records of 141 patients with primary trigeminal neuralgia admitted to Shandong Provincial Hospital from May 2011 to June 2013 were collected. Among them, 63 patients received MVD surgery and were set as group A, while the other 78 received MVD combined with PSR and were as group B. The efficacy and complication of the two treatment methods were compared. Multivariate logistic regression was performed to analyze the risk factors for treatment efficacy. The total effective rate was 96.15% in group B, higher than that in group A (88.89%), but the difference was not statistically significant (P>0.05). The complications in group B were statistically less than that in group A (P<0.05). Risk factors for the onset of primary trigeminal neuralgia included the degree of decompression, duration of disease, degree of compression, and clinical symptoms. Patients treated with MVD combined with PSR had a better quality of life and lower 5-year recurrence rate than patients treated with MVD (both P<0.05). In conclusion, MVD combined with PSR treatment has good clinical efficacy in primary trigeminal neuralgia and low incidence of complications. The possible risk factors for the onset of primary trigeminal neuralgia include the degree of decompression, duration of disease, degree of compression, and clinical symptoms.

Clinical Analysis of the Treatment of Primary Trigeminal Neuralgia by Percutaneous Balloon Compression

“…At present, the surgical treatment of trigeminal neuralgia can be roughly divided into four categories: MVD, stereotactic gamma knife, PBC, and radiofrequency thermocoagulation with glycerol injection ( 11 ). After MVD, the complete pain relief rate can reach 90%, and after 10 years, the complete relief rate can be maintained at about 70%, and the incidence of surgical complications is low, which is the most ideal surgical scheme at present ( 12 ). However, this operation is complicated, which requires high technical requirements for the operator, and is not suitable for patients who are weak, old, or have serious systemic diseases and cannot tolerate craniotomy under general anesthesia.…”

Morbid Obesity and Diabetes Increase the Risk of Reoperation following Microvascular Decompression: A National Surgical Quality Improvement Program Analysis of 1,303 Patients

“…Microvascular decompression (MVD) is considered an excellent treatment for medically refractory trigeminal neuralgia (TN) and hemifacial spasm (HFS). 1,2 TN and HFS are thought to occur due to arterial or venous compression of associated cranial nerves at the nerve root entry zone on the brain stem. 3 The most common offending vessel in TN is either the superior cerebellar artery (SCA) or the anterior inferior cerebellar artery (AICA), while in HFS the AICA or the posterior inferior cerebellar artery (PICA) commonly compress the cranial nerve.…”

Trigeminal Nerve White Matter Fiber Abnormalities in Primary Trigeminal Neuralgia: A Diffusion Spectrum Imaging Study

“…Microvascular decompression (MVD), a minimally invasive interventional technique, is designed based on this etiological explanation and has been recognized as the most effective method for the treatment of TN ( 2 , 3 ). MVD can identify the painful nerve and effectively isolate the responsible vessels that compress the trigeminal nerve root and brainstem to relieve compression and, repair nerve pain under the operating microscope and eliminate the source of trigeminal nerve pain ( 4 ).…”