Anastasija Krzemińska, Marta Koźba-Gosztyła, Joanna Bladowska, Bogdan Czapiga
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引用次数: 0
Abstract
Objective: To evaluate the effectiveness, safety, and patient satisfaction associated with microvascular decompression (MVD) in the treatment of trigeminal neuralgia (TN), and to identify clinical and surgical factors associated with postoperative outcomes and TN recurrence.
Methods: This retrospective single-center study included 28 patients with TN who underwent MVD between 2018 and 2025. Data on demographics, TN subtype, preoperative imaging, prior treatments, surgical findings, use of Teflon suture, and complications were analyzed. Outcomes were assessed using the Barrow Neurological Institute (BNI) Pain Intensity Scale at early postoperative and follow-up stages. Kaplan-Meier survival analysis was used to assess pain-free intervals. Patient satisfaction was evaluated based on willingness to undergo the surgery again.
Results: Classical TN was diagnosed in 75% of patients. Preoperative MRI correctly predicted the presence of a conflict in 20 of 26 patients who actually had one (76.9%). Immediate postoperative pain relief (BNI I-II) was achieved in 85.7% of patients, and recurrence occurred in 16.7% of initially pain-free individuals. The average pain-free period was 28.5 ± 29.4 months. The use of a Teflon suture did not significantly affect recurrence or outcome. Major complications occurred in 10.7% of cases and included CSF leak from the surgical wound, neuroinfection and hematoma. Patient satisfaction was high, with 82% stating they would choose to undergo MVD again. Better outcomes were significantly associated with classical TN subtype. No significant associations were found with age, sex, prior gamma knife therapy, or Teflon fixation technique.
Conclusions: in our cohort MVD was a highly effective and well-tolerated treatment for TN, particularly in classical cases, offering high rates of long-term pain relief and patient satisfaction. Complications were rare in our cohort. Outcomes were not influenced by Teflon suture use or demographic factors, supporting the role of MVD as a first-line surgical option in appropriate candidates.
期刊介绍：
The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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