Comparing Percutaneous Treatments of Trigeminal Neuralgia: 19 Years of Experience in a Single Centre

三叉神经痛 医学 气球 射频热凝 经皮 外科 麻醉
作者
Imran Noorani,Amanda Lodge,Girish Vajramani,Owen Sparrow
出处
期刊:Stereotactic and Functional Neurosurgery [Karger Publishers]
卷期号:94 (2): 75-85 被引量:52
标识
DOI:10.1159/000445077
摘要

<b><i>Background:</i></b> Glycerol rhizolysis, thermocoagulation, and balloon compression are well established in the treatment of trigeminal neuralgia. <b><i>Objective:</i></b> To compare the outcome profile of these 3 percutaneous procedures in a single centre over a long follow-up period. <b><i>Methods:</i></b> Over 19 years, 393 procedures were performed on 210 trigeminal neuralgia patients. Patient records and telephone follow-up were used to determine demographic and operative details and surgical outcomes. The length of follow-up extended to over 17 years. <b><i>Results:</i></b> The initial rates of complete pain relief with or without medication were 72% for glycerol, 80% for thermocoagulation, and 86% for balloon compression. Kaplan-Meier analysis of recurrence times showed that balloon compression provides significantly longer relief than the other 2 procedures. Complication rates for glycerol, thermocoagulation, and balloon compression were 30.3, 27.1, and 43.5%, respectively. Analysis of repeat procedures showed no difference in recurrence times for balloon compression or thermocoagulation compared with primary procedures, but repeat glycerol procedures gave shorter recurrence times. <b><i>Conclusion:</i></b> Balloon compression provides longer pain relief than glycerol and thermocoagulation. Although balloon compression is more likely to give numbness and complications, the complications are largely minor and transitory. Moreover, balloon compression following previous percutaneous procedures remains highly effective.

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