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Acta Neurochirurgica

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01-11-2017 | Original Article - Functional

Long-term outcomes of microvascular decompression and Gamma Knife surgery for trigeminal neuralgia: a retrospective comparison study

Authors: Takuro Inoue, Hisao Hirai, Ayako Shima, Fumio Suzuki, Masayuki Yamaji, Takanori Fukushima, Masayuki Matsuda

Published in: Acta Neurochirurgica | Issue 11/2017

Abstract

Background

There is still no clear guideline for surgical treatment for patients with medically refractory trigeminal neuralgia (TN). When it comes to which surgical treatment to choose, microvascular decompression (MVD) or Gamma Knife surgery (GKS), we should know the long-term outcome of each treatment.

Methods

We analyzed 179 patients undergoing MVD and 52 patients undergoing GKS followed for 1 year or longer. We evaluated the patient’s neurological status including pain relief, complications and recurrence. Results were assessed with Barrow Neurological Institute (BNI) pain intensity and facial numbness scores. Overall outcomes were compared between the two groups based on pain relief and complications.

Results

BNI pain intensity and facial numbness scores at the final visit were significantly lower in the MVD group than in the GKS group (P < 0.001, P = 0.04, respectively). Overall outcomes were superior following MVD than following GKS (P < 0.001). Following whichever treatment, there were initially high rates of pain-free status “without medication”: 96.6% in the MVD group and 96.2% in the GKS group. However, 6.1% in the MVD group and 51.9% in the GKS group fell into a “with medication” state within median periods of 1.83 and 3.92 years, respectively (P < 0.001). Kaplan-Meier analysis revealed that pain recurred more often and later in the GKS group than in the MVD group (P < 0.001).

Conclusions

Considering the long-term outcomes, MVD should be chosen as the initial surgical treatment for patients with medically refractory TN.

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Title: Long-term outcomes of microvascular decompression and Gamma Knife surgery for trigeminal neuralgia: a retrospective comparison study
Authors: Takuro Inoue
Hisao Hirai
Ayako Shima
Fumio Suzuki
Masayuki Yamaji
Takanori Fukushima
Masayuki Matsuda
Publication date: 01-11-2017
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 11/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-017-3325-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Long-term outcomes of microvascular decompression and Gamma Knife surgery for trigeminal neuralgia: a retrospective comparison study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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