Analysis Of Related Factors In The Treatment Of Recurrent Trigeminal Neuralgia After MVD

Analysis of the related factors in the first part of MVD for the treatment of recurrent trigeminal neuralgiaBackground: primary trigeminal neuralgia(Trigeminal Neuralgia TN)is a kind of common diseases in Department of Neurosurgery,facial pain is paroxysmal pain in chewing,talking,wash face slight movements can induce the onset of a higher frequency.Microvascular decompression(Microvascular Decompression MVD)because of its relatively high cure rate,has gradually become the preferred surgical treatment in recent years for the treatment of primary TN,but there are still some patients even in MVD intraoperative decompression,postoperative remission of trigeminal neuralgia is still not very satisfactory,even in the short term according to reports in the literature did not change after MVD without remission rate can reach6% ~ 7.6%.Objective: To explore the related factors that affect the clinical efficacy of MVD in the treatment of primary TN,and to evaluate the risk of MVD for the recurrence of primary TN after operation.Determine the skill and plan of the operation and summarize the experience.Methods: a retrospective analysis from January 2012 to December 2014 admitted to Department of Neurosurgery the first people's Hospital of Shandong city in Jining Province,the 400 cases of surgical treatment of MVD patients with primary TN cases,the index statistics related factors of the patients themselves,and patients with postoperative recurrence index,and respectively were analyzed with single factor analysis and chi square test,Logistic multivariate regression analysis,to evaluate the independent risk factors affecting the clinical efficacy of primary MVD TN.Results: the total number of patients in this group was 400,and 36 cases had recurrence within 2 years after the operation.Female group the recurrence rate(9.9%)higher than the recurrence rate in male group(8%),no recurrence rate of vascular compression group(40%)was higher than that of vascular compression group recurrence rate(8.6%),the recurrence rate of each branch in pain group from high tolow were V2-3(13.4%),V2(12.5%),V1(9.1%),V3(7.5%),V1-2-3(4.4%),V1-2(4.3%),V1-3(0%),the difference was statistically significant(P<0.05).Single factor X 2 test analysis and parallel Logistic multivariate regression analysis showed that gender,blood pressure and pain branches were independent risk factors of MVD in the treatment of primary TN.Conclusion: 1,influence the pathogenic factors of recurrence of trigeminal neuralgia after MVD: gender,vascular compression,pain and no branch of vascular compression in patients with postoperative recurrence rate is high because of vascular compression,preoperative imaging diagnosis,intraoperative careful and systematic peripheral nerve root exploration.It is the key to reduce the recurrence rate of patients with surgery.The recurrence rate of the patients with 2,V2-3 and V2 branch pain was higher after MVD.According to law,we can according to the scope of the trigeminal nerve pain involved in preoperative evaluation of the higher risk of recurrent MVD therapy alone after the formulation of reasonable operation strategy,to reduce the possibility of recurrence,and can more accurately judge the prognosis of patients.