| Are the destructive neurosurgical techniques as effective as microvascular decompression in the management of trigeminal neuralgia? | |
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MedLine Citation:
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PMID: 17765958 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Mehdi Laghmari; Abdessamad El Ouahabi; Yasser Arkha; Said Derraz; Abdeslam El Khamlichi |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2007-09-04 |
Journal Detail:
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Title: Surgical neurology Volume: 68 ISSN: 0090-3019 ISO Abbreviation: Surg Neurol Publication Date: 2007 Nov |
Date Detail:
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Created Date: 2007-10-26 Completed Date: 2008-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0367070 Medline TA: Surg Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 505-12 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Hôpital des spécialités O.N.O, C.H.U Rabat, Morocco. mehdi_laghmari@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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