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Radiofrequency thermocoagulation rhizotomy for recurrent trigeminal neuralgia after microvascular decompression.
Chin Med J (Engl). 2011 Nov; 124(22):3726-30.CM

Abstract

BACKGROUND

Microvascular decompression (MVD) is a well accepted surgical treatment strategy for trigeminal neuralgia (TN) with satisfying long-term outcome. However, considerable recurrent patients need more effective management. The purpose of this study was to evaluate the effectiveness of radiofrequency thermocoagulation rhizotomy (RTR) on patients with recurrent TN after MVD.

METHODS

Totally 62 cases of recurrent TN after MVD undergoing RTR from January 2000 to January 2010 were retrospectively evaluated. Based on surgical procedures undertaken, these 62 cases were classified into two subgroups: group A consisted of 23 cases that underwent traditional RTR by free-hand; group B consisted of 39 cases that underwent RTR under the guidance of virtual reality imaging technique or neuronavigation system. The patients in group A were followed up for 14 to 70 months (mean, 40 ± 4), and those in group B were followed up for 13 to 65 months (mean, 46 ± 7). Kaplan-Meier analyses of the pain-free survival curves were used for the censored survival data, and the log-rank test was used to compare survival curves of the two groups.

RESULTS

All patients in both groups A and B attained immediate pain relief after RTR. Both groups attained good pain relief rate within the first two years of follow-up: 92.3%, 84.6% and 82.6%, 69.6% respectively (P > 0.05). After 2 years, the virtual reality or neuronavigation assisted RTR group (group B) demonstrated higher pain relief rates of 82.5%, 76.2% and 68.8% at 3, 4 and 5 years after operation respectively, while those in group A was 57.2%, 49.6%, and 36.4% (P < 0.05). Low levels of minor complications were recorded, while neither mortalities nor significant morbidity was documented.

CONCLUSIONS

RTR was effective in alleviating the pain of TN cases suffering from unsuccessful MVD management. With the help of virtual reality imaging technique or neuronavigation system, the patients could attain better long-term pain relief.

Authors+Show Affiliations

Department of Neurosurgery, Qilu Hospital, Shandong University, Jinan, Shandong 250012, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22340232

Citation

Zhang, Liang-Wen, et al. "Radiofrequency Thermocoagulation Rhizotomy for Recurrent Trigeminal Neuralgia After Microvascular Decompression." Chinese Medical Journal, vol. 124, no. 22, 2011, pp. 3726-30.
Zhang LW, Liu YG, Wu CY, et al. Radiofrequency thermocoagulation rhizotomy for recurrent trigeminal neuralgia after microvascular decompression. Chin Med J (Engl). 2011;124(22):3726-30.
Zhang, L. W., Liu, Y. G., Wu, C. Y., Xu, S. J., & Zhu, S. G. (2011). Radiofrequency thermocoagulation rhizotomy for recurrent trigeminal neuralgia after microvascular decompression. Chinese Medical Journal, 124(22), 3726-30.
Zhang LW, et al. Radiofrequency Thermocoagulation Rhizotomy for Recurrent Trigeminal Neuralgia After Microvascular Decompression. Chin Med J (Engl). 2011;124(22):3726-30. PubMed PMID: 22340232.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiofrequency thermocoagulation rhizotomy for recurrent trigeminal neuralgia after microvascular decompression. AU - Zhang,Liang-Wen, AU - Liu,Yu-Guang, AU - Wu,Cheng-Yuan, AU - Xu,Shu-Jun, AU - Zhu,Shu-Gan, PY - 2012/2/21/entrez PY - 2012/2/22/pubmed PY - 2012/7/13/medline SP - 3726 EP - 30 JF - Chinese medical journal JO - Chin Med J (Engl) VL - 124 IS - 22 N2 - BACKGROUND: Microvascular decompression (MVD) is a well accepted surgical treatment strategy for trigeminal neuralgia (TN) with satisfying long-term outcome. However, considerable recurrent patients need more effective management. The purpose of this study was to evaluate the effectiveness of radiofrequency thermocoagulation rhizotomy (RTR) on patients with recurrent TN after MVD. METHODS: Totally 62 cases of recurrent TN after MVD undergoing RTR from January 2000 to January 2010 were retrospectively evaluated. Based on surgical procedures undertaken, these 62 cases were classified into two subgroups: group A consisted of 23 cases that underwent traditional RTR by free-hand; group B consisted of 39 cases that underwent RTR under the guidance of virtual reality imaging technique or neuronavigation system. The patients in group A were followed up for 14 to 70 months (mean, 40 ± 4), and those in group B were followed up for 13 to 65 months (mean, 46 ± 7). Kaplan-Meier analyses of the pain-free survival curves were used for the censored survival data, and the log-rank test was used to compare survival curves of the two groups. RESULTS: All patients in both groups A and B attained immediate pain relief after RTR. Both groups attained good pain relief rate within the first two years of follow-up: 92.3%, 84.6% and 82.6%, 69.6% respectively (P > 0.05). After 2 years, the virtual reality or neuronavigation assisted RTR group (group B) demonstrated higher pain relief rates of 82.5%, 76.2% and 68.8% at 3, 4 and 5 years after operation respectively, while those in group A was 57.2%, 49.6%, and 36.4% (P < 0.05). Low levels of minor complications were recorded, while neither mortalities nor significant morbidity was documented. CONCLUSIONS: RTR was effective in alleviating the pain of TN cases suffering from unsuccessful MVD management. With the help of virtual reality imaging technique or neuronavigation system, the patients could attain better long-term pain relief. SN - 2542-5641 UR - https://www.unboundmedicine.com/medline/citation/22340232/Radiofrequency_thermocoagulation_rhizotomy_for_recurrent_trigeminal_neuralgia_after_microvascular_decompression_ L2 - https://Insights.ovid.com/pubmed?pmid=22340232 DB - PRIME DP - Unbound Medicine ER -