Short-term Curative Effect Of Microvascular Decompression And Percutaneous Balloon Compression For Trigeminal Neuralgia

ObjectiveTrigeminal neuralgia(TN)is a sudden pain in the distribution area of the trigeminal nerve,which seriously affects the daily life of patients,and the pathogenesis is still unclear.At present,the efficacy of drug treatment is not good,surgical treatment including Microvascular decompression(MVD),Percutaneous balloon compression(PBC)is commonly used in clinical.Among them,MVD has high pain relief rate and low recurrence rate,but the trauma is large,operation time is long;PBC whose operation time is short and trauma is small,it is also can be repeatable,but the recurrence rate is high,this study compared Microvascular decompression(MVD)and Percutaneous balloon compression(PBC)to observe postoperative pain relief,recurrence and complications,to Investigate the factors that cause recurrence of trigeminal neuralgia,and provide empirical guidance for the future surgical treatment of trigeminal neuralgia.MethodsIn this study,from January 2013 to January 2018,109 cases,Diagnosis of trigeminal neuralgia,underwent classic microvascular decompression(MVD)and 116 cases underwent Percutaneous balloon compression(PBC),using O-arm combined with neuronavigation for intraoperative image fusion,are followed in neurosurgery at the Hospital.First,the basic information of gender,age,underlying disease,pain location,branch,course of disease,pain nature,previous surgical history,preoperative pain score,etc.were compared and analyzed;then visual analogue scale(VAS)and Barrow institute of neurology pain score(BNI)was used to assess the pain relief immediate,3 months,6 months,and 12 months after surgery,and the recurrence of pain 3 months,6 months,and 12 months after surgery.The chi-square test was used to compare the two groups.Differences in pain relief,recurrence,and complications,and analysis of factors associated with recurrence of trigeminal neuralgia.ResultsThe results of this study showed that patients with trigeminal neuralgia had higher pain relief rates after above two procedures,and pain relief rates of the MVD group was slightly higher than the PBC group,There was no significant difference in pain relief rates of the 6 months,and 12 months after surgery.However,there was a difference in pain relief rates between the two groups in immediately and in 3 months.after surgery.in addition,there was no significant difference in the rate of pain relief between the two groups in the elderly(>65 years),those with vascular compression,and initial surgery.There was also no significant difference in the recurrence rate between the two procedures at half a year and one year after surgery.The recurrence of pain may be related to gender,previous surgical history,and vascular compression.The complications were different between the two groups.The incidence of scalp numbness was higher in the MVD group.The incidence of facial numbness in the PBC group was significantly higher than that in the MVD group.There was no difference in patient satisfaction between the two procedures.In the hospitalization time,cost and operation time,the PBC group was lower than the MVD group.ConclusionsThis study showed that MVD and PBC treatment of trigeminal neuralgia have a good effect and the recurrence rate is not high in recently,but the complications of the two procedures are not the same,PBC in the health economics of hospitalization costs,time and operation time Better than MVD.patients have higher satisfaction with both procedures.PBC may be expected to be a new and preferred surgical procedure for trigeminal neuralgia surgery.