Microvascular decompression for trigeminal neuralgia: A retrospective analysis of long-term outcomes and prognostic factors

• DOI: 10.1016/j.nrleng.2021.03.010
• Publication Date: 2023-11-22T01:59:13Z
• Authors: L. Amaya Pascasio; B. De La Casa-Fages; E. Esteban de Ant...; F. Grandas; R. García-Leal; F. Ruiz Juretschke
• Keywords: Cirugía de neuralgia del trigémino; Pain; Neuralgia del trigémino refractaria; Middle Aged; Trigeminal Neuralgia; Compresión neurovascular; Prognosis; 3. Good health; Microvascular Decompression Surgery; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Humans; Neurology. Diseases of the nervous system; RC346-429; Aged; Retrospective Studies

Microvascular decompression is considered to be the most effective and only etiological surgical treatment for classical trigeminal neuralgia, relieving the neurovascular compression found in up to 95% of cases. This study aims to report the long-term outcomes and to identify prognostic factors in a series of patients with trigeminal neuralgia treated by microvascular decompression.A retrospective observational study of 152 consecutive patients operated by microvascular decompression with at least six months of follow-up. The surgical results, including pain relief according to the Barrow Neurological Institute pain scale, complications and the medical treatment during the follow-up period were reviewed. Binary regression analysis was performed to identify factors associated with a good long-term outcome.A total of 152 patients with a mean age of 60 years and a mean follow-up of 43 months were included. At the final follow-up visit, 83% of the patients had achieved significant relief of the pain and 63% could reduce the absolute drug doses by 50% or more. The most frequent complications were wound infection (4.5%) and CSF fistula (7%). Being over 70 years of age and having paroxysmal pain were associated with a long-term pain relief.Our results support the notion that microvascular decompression is an effective and safe therapy in patients with trigeminal neuralgia. A multidisciplinary approach with an early referral to a neurosurgical unit many be beneficial in patients who are refractory to pharmacological treatment.