A Retrospective Analysis Of Radiofrequency Thermocoagulation For Trigeminal Neuralgia Under C-arm Guidance

Objective:To evaluate the long-term efficacy of percutaneous radiofrequency thermocoagulation for trigeminal neuralgia under C-arm guidance; To explore the related factors on the long-term outcome of this procedure.Methods:The clinical data of 202 trigeminal neuralgia patients admitted to Pain Clinic of Shandong Provincial Hospital from June 2009 to July 2014 who accepted radiofrequency thermocoagulation were retrospectively analyzed. Get the baseline characteristics, immediate outcome, duration pain-free and complications of the patients by the return visit and follow-up. The long-term pain-free rate and recurrence difference on gender, age, affected side, affected branch and the temperature of radiofrequency thermocoagulation were assessed by Kaplan-Meier analysis and chi-square test.Results:The effective rate of the 202 patients were 100%.141 patients have accomplished follow-up and 31 of them recurred. The results of Kaplan-Meier analysis and chi-square test showed no significant differences on gender, age, affected side and the temperature of radiofrequency thermocoagulation(P> 0.05).However, the long-term outcome of isolated 3rd-division trigeminal neuralgia patients(V3 TN) was significantly greater than isolated 2nd-division(V2 TN) and both 2nd-and 3rd-division trigeminal neuralgia patients(V2+V3 TN) (P<0.05).And there was no significant difference between V2 TN and V2+V3 TN (P>0.05). The pain-free rate of V3 TN was 98.6%、86%、77.8%; the pain-free rate of V2 TN was 79.2%、59.1%、 53.7%; the pain-free rate of V2+V3 TN was 82.7%、76.4%、69.4%(12,36, and 60 months, respectively).Conclusions:1, Under C-arm guidance,Percutaneous radiofrequency thermocoagulation for PTN is a safe and effective method,for the V2 TN and(or) V3 TN;2, Gender, age and affected side have not showed the statistical difference to the long-term outcome of radiofrequency thermocoagulation for trigeminal neuralgia;3, The long-term outcome of radiofrequency thermocoagulation for V3 TN is greater than V2 TN or V2+V3 TN;4,There are no difference on the long-term efficacy between lower temperature group(<80℃) and higher temperature group (≥80℃).Therefore, we should avoid obtaining better efficacy by increasing the temperature of the radiofrequency thermocoagulation.