Document Detail


Are the destructive neurosurgical techniques as effective as microvascular decompression in the management of trigeminal neuralgia?
MedLine Citation:
PMID:  17765958     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There are no randomized controlled trials comparing TC, PTGC, and MVD for idiopathic TN at a single institution using quality criteria. The aim of the study was to assess the long-term outcome (efficiency and morbidity) of treated patients with one of these techniques in the same institution. METHODS: The authors present a retrospective study of 165 consecutive patients from 1983 to 2004. The inclusion criteria were drug-resistant idiopathic TN and intolerance to medical treatment. Three groups were set up according to the techniques used: group I (n = 73), treated by TC; group II (n = 41), treated by PTGC; group III (n = 51), treated by MVD. The main judgment criterion was pain relief. The second judgment criterion was morbidity. chi(2) or Fisher exact test, Kaplan-Meier, and log-rank were used for statistical analysis. RESULTS: The 3 groups were homogeneous according to age, duration of evolution, and pain topography. Concerning sex, groups I and II were different (women, 58%; vs. 37%; P = .021). The immediate efficiency for the 3 groups was, respectively, 96%, 94%, and 95% (NS). At 6 years follow-up, 70%, 77%, and 72% of the patients, respectively, remained pain-free (NS). As determined by the Kaplan-Meier survival curve, there was no difference between the 3 groups (log-rank, P = .867). Hypoesthesia was more frequent for PTGC (89%). CONCLUSIONS: In our study, we did not find MVD to be more effective than the other techniques. However, it had the lowest long-term complication rate, which is a strong argument in choosing this technique as the initial procedure for young and healthy patients. Percutaneous techniques, however, are still recommended in specific circumstances.
Authors:
Mehdi Laghmari; Abdessamad El Ouahabi; Yasser Arkha; Said Derraz; Abdeslam El Khamlichi
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-09-04
Journal Detail:
Title:  Surgical neurology     Volume:  68     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-26     Completed Date:  2008-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  505-12     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Hôpital des spécialités O.N.O, C.H.U Rabat, Morocco. mehdi_laghmari@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Balloon Dilatation*
Catheter Ablation*
Decompression, Surgical*
Female
Follow-Up Studies
Humans
Male
Microsurgery*
Middle Aged
Retrospective Studies
Rhizotomy*
Time Factors
Treatment Outcome
Trigeminal Neuralgia / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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