| Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia. | |
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MedLine Citation:
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PMID: 15046666 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: There are no randomized controlled trials comparing retrogasserian percutaneous radiofrequency thermocoagulation, glycerol rhizolysis, balloon compression of the gasserian ganglion, and stereotactic radiosurgery, nor are there systematic reviews using predefined quality criteria. The objective of this study was to systematically identify all of the studies reporting outcomes and complications of ablative techniques for treatment of trigeminal neuralgia, from the development of electronic databases, and to evaluate them with predefined quality criteria. METHODS: Inclusion criteria for the outcome analysis included thorough demographic documentation, defined diagnostic and outcome criteria, a minimum of 30 patients treated and median/mean follow-up times of 12 months, not more than 20% of patients lost to follow-up monitoring, Kaplan-Meier actuarial analysis of individual procedures, less than 10% of patients retreated because of failure or early recurrence, and a minimal dose of 70 Gy for stereotactic radiosurgery. High-quality studies with no actuarial analysis were used for the evaluation of complications. RESULTS: Of 175 studies identified, 9 could be used to evaluate rates of complete pain relief on a yearly basis and 22 could be used to evaluate complications. In mixed series, radiofrequency thermocoagulation offered higher rates of complete pain relief, compared with glycerol rhizolysis and stereotactic radiosurgery, although it demonstrated the greatest number of complications. CONCLUSION: Radiofrequency thermocoagulation offers the highest rates of complete pain relief, although further data on balloon microcompression are required. It is essential that uniform outcome measures and actuarial methods be universally adopted for the reporting of surgical results. Randomized controlled trials are required to reliably evaluate new surgical techniques. |
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Authors:
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Benjamin C Lopez; Peter J Hamlyn; Joanna M Zakrzewska |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Neurosurgery Volume: 54 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 2004 Apr |
Date Detail:
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Created Date: 2004-03-29 Completed Date: 2004-07-30 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 973-82; discussion 982-3 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, The Royal London Hospital, Barts and the London National Health Service Trust, Queen Mary's and St. Bartholomew's School of Medicine, Denamrk Hill, London SE5 9RS, England, UK. Benjamin.Lopez@kingsch.nhs.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Clinical Trials as Topic Data Interpretation, Statistical Humans Neurosurgery / methods*, standards Outcome Assessment (Health Care) Postoperative Complications / etiology Quality Control Trigeminal Ganglion / surgery Trigeminal Neuralgia / diagnosis, surgery* |
| Comments/Corrections | |
Comment In:
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Neurosurgery. 2005 Sep;57(3):E601
[PMID:
16145518
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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