Meta-analysis Of The Effect Of Microvascular Decompression And Balloon Compression In The Treatment Of Trigeminal Neuralgia

Objective:To investigate the efficacy of microvascular decompression(MVD)and percutaneous balloon/microsphere compression(PBC/PMC)in the treatment of trigeminal neuralgia to provide theory evidence for clinical practice by Meta-analysis of published literatures at home and abroad.Methods:We retrieved the relevant documents collected between the establishment of the database and March 2019 by computer,including CNKI,Wanfang databases,Weipu databases,Pubmed,Embase and Cochrane Library according to inclusion and exclusion criteria.Newcastle-Ottawa scale and Jadad scale were used to evaluate the quality of literatures,and Stata 15.0 software was used for meta-analysis.Data extraction,data analysis,heterogeneity test,publication bias and sensitivity analysis were analyzed in turn.Results:A total of nine articles were included in the meta-analysis.The results showed that there was no significant difference in the immediate relief rate of trigeminal neuralgia between PBC/PMC and MVD(OR = 0.41,95% CI: 0.16-1.06,P = 0.066).There was significant difference in the cure rate after follow-up period(OR = 0.54,95% CI:0.49-0.72,P = 0.00),suggesting that the cure rate of MVD was higher than that ofPBC/PMC.The difference of remission rate was significant(OR = 0.50,95% CI:0.30-0.86,P = 0.011),suggesting that the remission rate of MVD was higher than that of PBC/PMC.The recurrence rate was significantly different(OR = 0.2,42,95% CI:1.43-4.10,P = 0.001),suggesting that the recurrence rate of MVD was lower than that of PBC/PMC.The incidence of herpes simplex was significantly different(OR = 2.25,95%CI: 1.42-3.56,P = 0.001),suggesting that the incidence of MVD herpes was lower than that of PBC/PMC.There were significant differences in the incidence of facial numbness(OR = 41.6,95% CI: 24.62-70.48,P = 0.000),suggesting that the incidence of facial numbness in MVD was lower than that in PBC/PMC.The incidence of masseter muscle weakness was significantly different(OR = 20.11,95% CI: 2.84-142.56,P = 0.003),suggesting that the incidence of MVD masseter muscle weakness was lower than that of PBC/PMC.Conclusion:This study shows that MVD and PBC/PMC have the same effect on immediate relief of pain after operation.In terms of recurrence rate and complications,MVD is the first choice for the treatment of primary trigeminal neuralgia without other complications.For recurrent trigeminal neuralgia,elderly patients who do not undergo craniotomy or do not tolerate surgery,PBC/PMC is also an appropriate choice.