| Objective: Microvascular decompression(MVD)is an effective surgical treatment for classical trigeminal neuralgia(CTN).However,it is not uncommon for patients with no pain relief or recurrence.The purpose of this study was to explore the contributing factors of the effectiveness of MVD for classical trigeminal neuralgia,and with the purpose to improve the efficacy of MVD.Methods: The clinical data of 99 patients with TN who underwent MVD treatment from January 2014 to November 2019 in the Department of Neurosurgery of the Brain Hospital of Nanjing Medical University were retrospective analyzed.The postoperative efficacy was followed up through outpatient and telephone ask.A single factor analysis was used to analyze the relationship between each factor and the effectiveness,and relevant factors were screened out,then they were used in the Logistic and Cox regression models to analyze the predictors of postoperative efficacy.Results: Eighty-six were completely painless(BNI I)after surgery,and immediate remission rate was 86.9%.Logistic regression multivariate analysis showed that typical TN was an independent predictor of short-term efficacy.Kaplan-Meier survival analysis showed that the pain relief rates of TN patients at 1 year,3 years,and 5 years were 86.7%,73.9%,and 70.7%,respectively.Multivariate Cox regression analysis showed that age ≥ 60 years,duration <5 years,arterial compression and typical TN were independent predictors of good long-term outcomes.Conclusion: MVD is the only treatment of TN for "pathogenesis".Patients receiving MVD can obtain satisfactory results.The disease course,age,culprit vessels,and clinical presentation have certain effects on the efficacy of MVD. |
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