Document Detail


Systematic review of ablative neurosurgical techniques for the treatment of trigeminal neuralgia.
MedLine Citation:
PMID:  15046666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Benjamin C Lopez; Peter J Hamlyn; Joanna M Zakrzewska
Related Documents :
21669146 - Pridie's marrow stimulation technique combined with collagen matrix for cartilage repai...
18503336 - How soon will the patient with metastasis return for radiosurgery?
8160096 - Radiation therapy for brain metastases from lung carcinoma. prospective randomized tria...
12494356 - Gamma knife radiosurgery in the management of arteriovenous malformations of the basal ...
15197626 - Percutaneous transpedicular discectomy and drainage in pyogenic spondylodiscitis.
18176936 - Systematic review and meta-analysis of randomized controlled trials comparing stapled h...
Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Neurosurgery     Volume:  54     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-29     Completed Date:  2004-07-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  973-82; discussion 982-3     Citation Subset:  IM    
Affiliation:
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:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
Neurosurgery. 2005 Sep;57(3):E601   [PMID:  16145518 ]

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


Previous Document:  Endurance of aneurysm clips: mechanical endurance of Yaşargil and Spetzler titanium aneurysm clips.
Next Document:  Father of neurosurgery in Hong Kong.