Effects of microvascular decompression on quality-of-life in trigeminal neuralgia patients aged 70 years and older

Wataru Yoshizaki; Yoshiki Fujikawa; Sadaharu Torikoshi; Toshiro Katayama; Koichi Iwasaki; Hiroki Toda

doi:10.25259/SNI_997_2022

Effects of microvascular decompression on quality-of-life in trigeminal neuralgia patients aged 70 years and older

Surg Neurol Int. 2023 Feb 3:14:41. doi: 10.25259/SNI_997_2022. eCollection 2023.

Authors

Wataru Yoshizaki¹, Yoshiki Fujikawa¹, Sadaharu Torikoshi², Toshiro Katayama³, Koichi Iwasaki¹, Hiroki Toda¹

Affiliations

¹ Department of Neurosurgery, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka.
² Department of Neurosurgery, Japanese Red Cross Fukui Hospital, Fukui.
³ Department of Health Science, Graduate School of Health Science, Morinomiya University of Medical Sciences, Osaka, Japan.

Abstract

Background: Trigeminal neuralgia (TN) occasionally affects older adults, frequently worsens, and becomes refractory to medication. Older adult patients with TN may consider microvascular decompression (MVD) for their treatment. No study examines MVD effects on older adult TN patients' health-related quality of life (HRQoL). The present study evaluates the HRQoL of TN patients aged 70 years and older before and after MVD.

Methods: Adult TN patients who underwent MVD evaluated their HRQoL using the 36-Item Short-form (SF-36) Health Survey before and 6 months after MVD. The patients were divided into four groups according to their decade of age. The clinical parameters and operative outcomes were analyzed statistically. The SF-36 physical, mental, and role social component summary scores and eight domain scale scores were analyzed using a twoway repeated-measures analysis of variance (ANOVA) to compare the effects of age group and preoperative and postoperative time points.

Results: Among 57 adult patients (34 women, 23 men; mean age, 69 years; range, 30-89 years), 21 patients were in their seventies, and 11 were in their eighties. The SF-36 scores of patients in all age groups improved after MVD. Two-way repeated-measures ANOVA demonstrated a significant age group effect on the physical component summary and its physical functioning domain. A time point effect was significant on all component summaries and domains. There was a significant interaction between age group and time point effects on the bodily pain domain. These results suggested that patients 70 years and older had significant postoperative HRQoL improvement, but their improvement of physical-related HRQoL and multiple physical pain issues were limited.

Conclusion: Impaired HRQoL in TN patients aged 70 years and older can improve after MVD. Careful management of multiple comorbidities and surgical risks enables MVD to be an appropriate treatment for older adult patients with refractory TN.

Keywords: 36-Item short-form health survey (SF-36); Health-related quality of life; Microvascular decompression; Older adult; Trigeminal neuralgia.