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Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia.

Publication ,  Journal Article
Theodros, D; Rory Goodwin, C; Bender, MT; Zhou, X; Garzon-Muvdi, T; De la Garza-Ramos, R; Abu-Bonsrah, N; Mathios, D; Blitz, AM; Olivi, A ...
Published in: J Neurosurg
May 2017

OBJECTIVE Trigeminal neuralgia (TN) is characterized by intermittent, paroxysmal, and lancinating pain along the distribution of the trigeminal nerve. Microvascular decompression (MVD) directly addresses compression of the trigeminal nerve. The purpose of this study was to determine whether patients undergoing MVD as their first surgical intervention experience greater pain control than patients who undergo subsequent MVD. METHODS A retrospective review of patient records from 1998 to 2015 identified a total of 942 patients with TN and 500 patients who underwent MVD. After excluding several cases, 306 patients underwent MVD as their first surgical intervention and 175 patients underwent subsequent MVD. Demographics and clinicopathological data and outcomes were obtained for analysis. RESULTS In patients who underwent subsequent MVD, surgical intervention was performed at an older age (55.22 vs 49.98 years old, p < 0.0001) and the duration of symptoms was greater (7.22 vs 4.45 years, p < 0.0001) than for patients in whom MVD was their first surgical intervention. Patients who underwent initial MVD had improved pain relief and no improvement in pain rates compared with those who had subsequent MVD (95.8% and 4.2% vs 90.3% and 9.7%, respectively, p = 0.0041). Patients who underwent initial MVD had significantly lower rates of facial numbness in the pre- and postoperative periods compared with patients who underwent subsequent MVD (p < 0.0001). The number of complications in both groups was similar (p = 0.4572). CONCLUSIONS The results demonstrate that patients who underwent other procedures prior to MVD had less pain relief and a higher incidence of facial numbness despite rates of complications similar to patients who underwent MVD as their first surgical intervention.

Duke Scholars

Published In

J Neurosurg

DOI

EISSN

1933-0693

Publication Date

May 2017

Volume

126

Issue

5

Start / End Page

1691 / 1697

Location

United States

Related Subject Headings

  • Trigeminal Neuralgia
  • Treatment Outcome
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Pain Measurement
  • Neurology & Neurosurgery
  • Middle Aged
  • Microvascular Decompression Surgery
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Theodros, D., Rory Goodwin, C., Bender, M. T., Zhou, X., Garzon-Muvdi, T., De la Garza-Ramos, R., … Lim, M. (2017). Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia. J Neurosurg, 126(5), 1691–1697. https://doi.org/10.3171/2016.5.JNS151692
Theodros, Debebe, C. Rory Goodwin, Matthew T. Bender, Xin Zhou, Tomas Garzon-Muvdi, Rafael De la Garza-Ramos, Nancy Abu-Bonsrah, et al. “Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia.J Neurosurg 126, no. 5 (May 2017): 1691–97. https://doi.org/10.3171/2016.5.JNS151692.
Theodros D, Rory Goodwin C, Bender MT, Zhou X, Garzon-Muvdi T, De la Garza-Ramos R, et al. Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia. J Neurosurg. 2017 May;126(5):1691–7.
Theodros, Debebe, et al. “Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia.J Neurosurg, vol. 126, no. 5, May 2017, pp. 1691–97. Pubmed, doi:10.3171/2016.5.JNS151692.
Theodros D, Rory Goodwin C, Bender MT, Zhou X, Garzon-Muvdi T, De la Garza-Ramos R, Abu-Bonsrah N, Mathios D, Blitz AM, Olivi A, Carson B, Bettegowda C, Lim M. Efficacy of primary microvascular decompression versus subsequent microvascular decompression for trigeminal neuralgia. J Neurosurg. 2017 May;126(5):1691–1697.

Published In

J Neurosurg

DOI

EISSN

1933-0693

Publication Date

May 2017

Volume

126

Issue

5

Start / End Page

1691 / 1697

Location

United States

Related Subject Headings

  • Trigeminal Neuralgia
  • Treatment Outcome
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Pain Measurement
  • Neurology & Neurosurgery
  • Middle Aged
  • Microvascular Decompression Surgery
  • Male