Analysis Of The Therapeutic Effects Of Three Surgery Procedures On Primary Trigeminal Neuralgia

Objective:To compare the curative effects and complications when using microvascular decompression (MVD)-gamma knife surgery (GKS) and radiofrequency thermocoagulation (RF) to treat primary trigeminal neuralgia (PTN). And to evaluate the prognosis for PTN after different treatments.Methods:63patients were enrolled from June2010to June2013of which18patients underwent microvascular decompression,24patients underwent gamma knife surgery and21patients underwent Radiofrequency thermocoagulation. Analyze the follow-up data to compare the curative effects and complications.Results:Cumulative pain relief rates at1week,3,6,12months and the end time after treatment were88.9%,94.4%,94.4%,94.4%,94.4%respectively in MVD group. Cumulative pain relief rates at1week,3,6,12months and the end time after treatment were20.8%,54.2%,79.2%,87.5%,87.5%respectively in GKS group; While in RF group, Cumulative pain relief rates at1week,3,6,12months and the end time after treatment were85.7%,90.5%,90.5%,85.7%,81.0%respectively. In GKS group, the cumulative pain relief rates at1week and3months were significantly lower than other groups (P<0.05). The one year relapse rates were0%,4.2%,9.5%respectively in MVD group, GKS group and RF group. There were no significant differences (P>0.05). The long-term incidence rates of complications were0%,4.2%,71.4%respectively in MVD group, GKS group and RF group. The long-term incidence rate of complications in RF group was significantly higher than other groups.Conclusion:The three methods are all effective. MVD is the first choice for the patients that can resistant to surgical treatment. GKS takes a long time to release pain and RF shows a higher incidence rate of complications. Meanwhile, GSK or RF may be a wise choose for the patients who can’t tolerate or refuse surgery.