Microvascular Decompression In The Treatment Of Primary Trigeminal Neuralgia:Clinical Analysis Of51Cases

Objective:To explore the cause of primary trigeminal neuralgia as well as the clinical effect and related factors on the treatment of primary trigeminal neuralgia by microvascular decompression.Methods:The clinical data of51patients with primary trigeminal neuralgia treated by microvascular decompression from September2012to September2013in The First Affiliated Hospital of Kunming Medical University were analyzed retrospectively. The clinical symptoms, operative findings and follow-up outcomes of51patients were analyzed. Follow-up time from6months to18months. Factors that may affect the efficacy of surgery were analyzed:the patients’ age, gender, affected side, course of disease, clinical type, the degree of compression and decompression.Results:According to the clinical type,51patients were divided into typical trigeminal neuralgia (44) and atypical trigeminal neuralgia (7).42patients had simple offending vessel during the operation, in which36were arterial compression and6were venous compression.8patients were multiple offending vessels, which were6arteriovenous compression and2bis-arterial compression. The last patient was compression of arachnoid thickening. By freeing the nerve from the compressive vessel(s),46patients were complete decompressed and5patients were incompletion. In our51patient series results were cure in41, excellent in4and effective in2by follow-up visit:40cure and4excellent were observed in44patients with typical trigeminal neuralgia and1cure,4excellent and2effective were in7patients with atypical trigeminal neuralgia. There were statistics differences between the typical and atypical trigeminal neuralgia by complete random design (P=0.024). Statistical analysis of single factor Logistic regress had not shown any significant influence on age, gender and side (P>0.05), but there’s significant influence on type, course, compression degree and decompression degree (P<0.05). Statistical analysis of multiple factors Logistic regress had shown significant influence on course, compression degree, compression nature and decompression degree (P<0.05).Conclusions:Microvascular decompression is an idea cure for primary trigeminal neuralgia which is the only therapy targeted on the cause of this disease. The effect is definite and outcome is fine. There’s no significant influence on age, gender and side. However, significant influences are proved in type, course, compression degree and decompression degree. Accordingly, patients with trigeminal neuralgia should be diagnosed and treated early and in time so that can avoid delaying to be bad outcome. Moreover, surgeons should pay attention to probe the whole trigeminal during operation to ensure decompressing sufficiently, which comes to the result of better surgical treatment.