Treatment of Redo-microvascular Decompression or Internal Neurolysis Plus Microvascular Decompression for Recurrent Trigeminal Neuralgia: a Review of Long-term Effectiveness and Safety

Overview

Journal J Int Med Res

Publisher Sage Publications

Specialty General Medicine

Date 2022 Mar 7

PMID 35249412

Authors

Baisheng Wang

Li Zhang

Yanbing Yu

Affiliations

Soon will be listed here.

Abstract

Objective: We examined the clinical characteristics and outcomes of patients with recurrent trigeminal neuralgia (TN) and assessed the long-term efficacy and safety of microvascular decompression (MVD) to treat typical recurrent TN.

Methods: We identified 3024 patients who underwent MVD for treatment of TN at the China-Japan Friendship Hospital from March 2009 to December 2020. We retrospectively analyzed the data and outcomes of 137 patients who underwent redo-MVD and 74 patients who did not undergo redo-MVD as the control group. These outcomes were evaluated using the Barrow Neurological Institute scoring system.

Results: Recurrence in 68 of the 137 patients was due to incomplete or absent decompression or new responsible vessels. To ensure thorough pain relief, redo-MVD should include decompression of both the trigeminal root entry zone and the peripheral nerve segments, where blood vessels can cause symptoms. Factors associated with reduced effectiveness of redo-MVD were no period of initial pain relief after the first MVD and a longer duration of symptoms before the first MVD.

Conclusions: Redo-MVD should not be excluded as a treatment option for patients with refractory TN who develop recurrent pain after a first MVD procedure.

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