Long-Term Outcomes of Percutaneous Balloon Compression for Trigeminal Neuralgia: A Retrospective Single-Center Study.

Objective: This study aimed to evaluate the long-term outcomes of percutaneous balloon compression (PBC) in individuals diagnosed with trigeminal neuralgia (TN) and to assess whether procedural modifications influence the durability of pain relief.

Methods: This retrospective study included patients diagnosed with TN who underwent PBC at the Department of Neurosurgery, Affiliated Hospital of Beihua University, between January 2017 and December 2025. Two procedural protocols were compared. In group A (treated from January 2017 to December 2020), balloon compression was maintained at baseline pressure for 180 seconds after achieving the optimal "pear shape." In group B (treated from January 2021 to December 2025), compression was maintained for 120 seconds at a pressure increased by 10% above baseline after pear shape formation. Postoperative pain relief, recurrence rates, and complication rates were compared between the 2 groups.

Results: Immediate postoperative pain relief rates within 24 hours did not differ significantly between the 2 groups (90.7% versus 97.6%; P=0.109). However, the 5-year recurrence rate was significantly lower in group B (9.6%) compared with group A (22.4%; P=0.043). The incidence of complications, excluding numbness, showed no significant difference between the groups (22.2% versus 27.1%; P=0.522).

Conclusions: A modified PBC technique involving an additional 10% increase in pressure for 120 seconds after optimal balloon positioning was associated with improved long-term pain control in patients with TN, without a corresponding increase in procedural complications. These findings suggest that procedural optimization may enhance the durability of therapeutic outcomes in PBC for this patient population.