Percutaneous Radiofrequency Rhizotomy Is Equally Effective for Trigeminal Neuralgia Patients with or Without Neurovascular Compression

Pain Med. 2022 Apr 8;23(4):807-814. doi: 10.1093/pm/pnab221.

Abstract

Background: Neurovascular compression (NVC) in patients with trigeminal neuralgia (TN) can be a factor of treatment outcome, especially in microvascular decompression and stereotactic radiosurgery. No such effect has been reported in percutaneous radiofrequency rhizotomy (RF). This study aims to investigate whether NVC affects the efficacy of RF in patients with TN.

Methods: We retrospectively reviewed patients with TN who received RF in our institution. Pretreatment magnetic resonance imaging was performed in every patient, and the presence of NVC was reviewed independently by two physicians. The patients were followed up at least for a year after the treatment. Pain severity was assessed with a numeric rating scale (NRS).

Results: Sixty-two patients were included in the study. All of the patients had single-sided lesions, and 35 patients had NVC. There were no significant differences between these two groups of patients in terms of gender distribution, age, and pretreatment pain severity. Comparable pain severity improvement was found at 1-year follow-up between these two groups (NRS 7.93 ± 0.492 without compression vs 7.57 ± 0.451 with compression, P = 0.600). No significant difference in posttreatment pain severity at 1 year was found between these two patient groups (NRS 1.37 ± 0.466 without compression vs 1.66 ± 0.458 with compression, P = 0.667).

Conclusions: For patients with TN treated by RF, the presence or absence of NVC is not likely to affect the 1-year pain control rate.

Keywords: Neuronavigation; Neurovascular Compression; Radiofrequency Rhizotomy; Trigeminal Neuralgia.

MeSH terms

  • Humans
  • Magnetic Resonance Imaging
  • Microvascular Decompression Surgery* / methods
  • Retrospective Studies
  • Rhizotomy
  • Treatment Outcome
  • Trigeminal Neuralgia* / surgery