Factors For Short-term Outcome And Long-term Outcome Of Primary Trigeminal Neuralgia Patients Following Microvascular Decopression

Objective: To investigate the factors for short-term outcome and long-term outcome of primary trigeminal neuralgia patients following microvascular decompression.To investigate the relation between the short-term outcome and the long-term outcome following microvascular decompression.Methods: Retrospectively analyzed the clinical data and follow-up data from 189 primary trigeminal neuralgia(PTN)patients following microvascular decompression(MVD)at the First Affiliated Hospital of Fujian Medical University from Jan 2016 to Dec 2019.BNI scored I-II within 3 days following MVD was defined as the good short-term outcome,while BNI scored III-V within 3 days following MVD was defined as the poor short-term outcome.And the enrolled patients were followed up at the outpatient department or by the phone call at a minimum of 12 months,postoperatively.BNI scored I-II at the follow-up was defined as the good long-term outcome,while BNI scored III-V at the follow-up was defined as the poor long-term outcome.The occurrence time of the poor long-term outcome was also recorded.Preoperative,intraoperative and postoperative variables were analyzed between the different outcome groups.The significant factors from univariate analyses(p<0.1)were entered into a multivariate logistic regression or a Cox regression analysis.Kaplan-Meier curve survival analysis and log-rank test were also used for the long-term outcome of PTN patients following MVD.p < 0.05 was considered significant.Results: Of the 189 patients enrolled in this study,149(78.8%)patients had the good short-term outcome following MVD and 40(21.2 %)patients had experienced the poor short-term outcome postoperatively.159(84.1%)patients had the good long-term outcome following MVD,and 30(15.9%)patients had experienced the poor long-term outcome at the follow-up examinations.The factors for the poor short-term outcomes following MVD were analyzed by multivariate logistic regression,including PTN duration > 5 years [OR=2.287(1.098-4.762),p < 0.05] or other cranial nerve compression [OR=3.178(1.009-10.008),p<0.05].The factors for the poor long-term outcomes following MVD were analyzed by Cox regression,including persistent PTN following MVD within 3 days [HR= 10.712(4.156-27.610),p < 0.01].And Kaplan-Meier survival curves had also evaluated the relation between the poor long-term outcome following MVD and persistent PTN following MVD within 3days(log-rank,p<0.01).Conclusion:MVD shows the excellent treatment outcome for PTN.PTN duration >5 years or other cranial nerve compression is independent factors that affects the short-term outcome of PTN patients following MVD.The PTN patients with PTN duration >5 years or other cranial nerve compression have higher prevalence of the poor short-term outcomes following MVD.Persistent PTN following MVD within 3days is the independent factor that affects the long-term outcome of PTN patients following MVD.The patients with persistent PTN following MVD within 3 days have higher prevalence of the poor long-term outcomes following MVD.And the short-term outcome following MVD can be used to predict the longt-term outcome following MVD.The PTN patients with poor short-term outcomes following MVD have higher prevalence of poor long-term outcomes following MVD.