Comparison Of Long-term Therapeutic Effects And Safety Between Microvascular Decompression And Gamma Knife Radiosurgery On Primary Trigeminal Neuralgia

Objective:To retrospectively compare the long-term therapeutic effects and safty between microvascular decompression and Gamma Knife radiosurgery surgery on primary trigeminal neuralgia. Methods: 56 trigeminal neuralgia patients from February 2011 to February 2013 in our hospital were randomly selected and divided into the microvascular decompression group(28 cases) and the Gamma Knife group(28 cases) according to condition of treatment. Mc Gi LL pain scale was used to evaluate the pain relief.The immediate remission rate after the operation, the three–year remission rate and the relapse rate were observed and enrolled by the means of telephone letters and outpatient recheck. 24 hours after treatment, follow-up of 6-month,one-year,two-year and three-year. Result: Follow-up was accomplished in 56 cases while each group 28 cases included for a duration more than three years. There was no significant difference of the 6-month to 3-year cure rate between the microvascular decompression group and the Gamma Knife group(P>0.05).The most complete relief of microvascular decompression consumed less than 24 hours while the gamma knife group needed 24 hours to 6 mouths. The immediately ease rate of the microvascular decompression group(92.9 percent) was higher than that of the Gamma Knife group(14.4 percent) with significant difference(P<0.01). The 3-year effective rate of the microvascular decompression group was higher than the Gamma Knife group with no significant difference(P>0.05). There were less complication occurred in the microvascular decompression group with significant difference(P>0.05)..The major complication of microvascular decompression was incision infection while paralysis of chops was more focused on in the treatment of gamma knife.There was no mortality in both two groups. Conclusion: Microvascular decompression is better than the gamma knife for the superior short-term pain relief and the decrease of the complication. The 3-year long-term therapeutic effects and safety no significant difference.