The Prognostic Factors Affecting Long-term Effectiveness Of Microvascular Decompression For Treatment Of Trigeminal Neuralgia-Systematic Review

OBJECTIVE:Microvascular decompression (MVD) is an effective treatment for trigeminal neuralgia (TN). However, many patients do not experience complete pain relief, and relapse can occur even after an initial excellent result. This systematic review was designed to assess the prognostic factors affecting long-term effectiveness of microvascular decompression for treatment of trigeminal neuralgia.METHODS:Databases including Pubmed,Medline,Cochrane Library,Web of science,China National Knowledge Infrastructure and WanFang data were retrieved to collect the prognostic factors affecting long-term outcome of microvascular decompression (MVD) for TN from 1985 to 2015. The collected articles were screened according to predetermined inclusion criteria. Data including authors, year of publishing, preoperative pain characteristics, number of patients with good immediate postoperative results, number of patients who had good long-term results after operation,number of patients suffering recurrence and duration of follow-up were extracted,and the methodological quality was assessed by Newcastle-Ottawa Scale(NOS). Statistic software CMA v2 was used to conduct analyses.RESULTS:Nineteen papers with 6,800 patients were finally enrolled in this review.The risk factors in long-term prognosis after MVD were female,younger than 60 years old,symptoms lasting more than eight years, venous or no vascular compression of the trigeminalroot entry zone,atypical TN,bilateral TN,and the lack of immediate postoperative pain-free.CONCLUSION:The long-term efficacy of MVD in TN is affected by the combination of various factors, which still needs to be confirmed by studies with large sample high-quality evidence for a long-term follow up.