Contributing factors to pain-free outcome in trigeminal neuralgia following microvascular decompression.

Abstract

Background: Trigeminal neuralgia (TN) is a disease that impairs patients' daily activities. Microvascular decompression (MVD) is known as the best procedure to relieve pain, yet a small portion of patients still experience pain after surgery. This study will analyze the prognostic factor of MVD for TN patients.

Methods: This is a retrospective cohort study of patients with TN who underwent MVD in an Indonesian tertiary hospital from January 2012 to December 2023. It combines medical records and patient interviews followed by statistical analysis to identify prognostic factors influencing the outcome of MVD for TN.

Results: Good response to carbamazepine is a favorable factor for short-term pain-free following MVD (P = 0.01). The type of pain emerged as the sole significant prognostic indicator for short-term (P < 0.001) and long-term (P = 0.04) pain relief following MVD. The duration of pain, the type of blood vessels compressing, and the location of compression demonstrated no statistically significant prognostic value on post-MVD pain-free outcomes.

Conclusion: MVD outcomes are influenced by several factors, including trigeminal pain type (for short and long-term outcomes) and response to carbamazepine (short-term outcomes). Conversely, other factors thought to influence MVD outcomes, such as the duration of pain, the type of blood vessel compressing the nerve, or the site of nerve compression, have not been proven to influence the procedure's outcome.