Analysis Of The Therapeutic Efficacy Of Microvascular Decompression For Idiopathic Trigeminal Neuralgia

Objective:To explore the clinical effect and related factors on the treatment of idiopathic trigeminal neuralgia by microvascular decompression.Methods: The clinical data of 34 patients with idiopathic trigeminal neuralgia treated by microvascular decompression between April 2006 and October 2010 in Guangxi medical univ- ersity first affiliated hospital neurosurgery department were retrospectively analyzed. Analysis of 34 cases of patients with clinical presentation, operative findings and follow -up outcomes. Follow-up time from six months to 6 years, an average of 41 months. Analysed all the factors of influence effect ofoperation prob- ably:the patients'age,gender,affected side,course of disease,clinical presentation,the degree of com- pression and decompression.Results: According to clinical characteristics,divided into typical trigeminal neuralgia group(23 cases)and atypical trigeminal neuralgia group(11 cases).In 34 patients,simple artery compression 28 cases (82.4%), including SCA, AICA, PICA, BA, and SCA+AICA, AICA+ PICA etc, 3 cases (8.8%) for arteries and veins while oppression; simple vein compression 2 cases (5.9%), no significant vascular compression of 1 cases (2.9%). Degree of 34 patients with neural decompression, full de- com- pression in 27 cases, of 7 patients with partial decompression. To the end of follow-up, cure for 23 cases of this group (67.6%), Excellent in 8 cases (23. 5%), effective 2 cases (5. 9%), invalid 1 cases (2. 9%), the total effective rate 97.1%. In 23 patients with typical TN, cure and exce- llent in 23 cases (100%); in 11 cases with atypical trigeminal neuralgia, cure and ex- cellent 8 cases (72.7%), effective 2 cases (18. 2%), invalid 1 cases (9.1%).The effect between the two groups had signifi- cant differ- ence (P<0. 05). Statistical analysis of the factors such as age,gender,affected side,disease course,clinical presentation,the degree of com- pression and decompression,suggested that clinical presentation,the disease course,the degree of compression and decompression were significantly correlated with the effect of surgery(P<0. 05).Conclusion: Microvascular decompression is an etiotropic, safe and effective treatment for idiopathic trigeminal neur- algia. It may be the first choice for healing ITN Microvascular decompression had better eff- ect in pain relief for patients with typical trigeminal neuralgia than pati- ents with atypical trigeminal neuralgia.The main factors affecting the effect of microvascular decompression were clinical presentation , dis- ease course,the degree of compression and decompression.