Treatment Of Primary Trigeminal Neuralgia By Selective Radiofrequency Thermocoagulation Guided With C-armed X-ray Fluoroscopy

Objective:To assess the efficacy of radiofrequency thermocoagulation guided with C-armed X-ray fluoroscopy on the treatment of primary trigeminal neuralgia in short term,mid-term,and long-term prospect.Methods:82 patients with primary trigeminal neuralgia were involved in the study.All cases were treated with radiofrequency thermocoagulation under X-ray fluoroscopy.Patients were randomly divided into 3 groups according to the highest temperature during radiofrequency thermocoagulation:80℃,86℃,90℃.The thermocoagulation duration was 60sec×3.The outcomes and side effects were observed in short term.The effects in mid-term and long term prospect were assessed in secondary follow-up.Results:75(91.46%)cases were successfully treated with a single procedure, and the remainder were treated with two procedures.All cases got an immediate pain relief after treatment without serious complications except one case had keratitis after procedure(rate was 1.22%).During the follow up,42 cases were followed between 6 to 30 months after treatment.Among them,11 cases reoccurred(rate was 26.2 %).During 6-month,12-month,24-month and 30-month,the recurrence rate were 7.1 %,19.0%,23.8%,26.2%respectively.26 cases suffered from facial numbness(rate was61.9%).Among different highest temperatures,there were no obvious differences in the rates of recurrence and numbness.There was no obvious correlation between recurrence and numbness.The numbness improved gradually.Conclusion:1.Selective radiofrequency thermocoagulation guided with C-armed X-ray fluoroscopy for the treatment of trigeminal neuralgia is an effective method.2.Among the temperature 80℃,86℃,90℃,80℃and 60sec×3,can cure trigeminal neuralgia clinically.3.Whether numbness disappeared,there was no effect on the recurrence.4.The numbness improved obviously 1 year after the procedure.