Efficacy and Prognostic Value of Partial Sensory Rhizotomy and Microvascular Decompression for Primary Trigeminal Neuralgia: A Comparative Study
Jian Gao, Yao Fu, Shi-Kun Guo, Bing Li, Zhong-Xin Xu
(Department of Neurosurgery, The China-Japan Union Hospital of Jilin University, Changchun, Jilin, China (mainland))
Med Sci Monit 2017; 23:2284-2291
This study aimed to compare the efficacy and prognostic value of partial sensory rhizotomy (PSR) and microvascular decompression (MVD) for primary trigeminal neuralgia (PTN).
MATERIAL AND METHODS: From June 2010 to June 2012, 117 patients with PTN were recruited for the study, of which 52 cases were treated with MVD (the MVD group) and 65 cases were treated with PSR (the PSR group). Visual Analog Scoring (VAS) was performed at 1 and 2 weeks, and at 1, 3, and 6 month after surgery. The overall response rate (ORR) was determined 1 month after surgery. Barrow Neurological Institute score was adopted to value the reoccurrence at 6, 12, 24, and 36 months after surgery. A 3-year follow-up was conducted and the complications were recorded.
RESULTS: The ORR 2 weeks after surgery in the MVD and PSR groups was 98.08% and 84.62%, respectively. One and 2 weeks after surgery, the VAS was lower in the MVD group than in the PSR group, but there was no significant difference in VAS between the 2 groups at 1, 3, and 6 months after surgery. Three years after surgery, the recurrence rate was significantly lower in the MVD group than in the PSR group. The recurrence-free survival time was longer in the MVD group than in the PSR group. The occurrence rates of herpes and total postoperative complications were significantly higher in the PSR group than in the MVD group.
CONCLUSIONS: Compared with PSR, MVD is more suitable for PTN treatment, with less disturbance, lower recurrence rate, and better efficacy.
Keywords: Comparative Study, Microvascular Decompression Surgery, Neuralgia, Rhizotomy, Treatment Outcome