Surgical treatment of trigeminal neuralgia: results of percutaneous treatment versus microsurgical decompression

A patient with trigeminal neuralgia may need different forms of treatment during his or her lifetime. Physicians should be aware of the different available surgical treatments, and know their effectiveness, side effects and complications. Microvascular decompression is considered by many to be the most effective treatment. The goal of the procedure is to remove the cause of pain, obtained by decompressing the nerve at its entry point into the pons. Percutaneous procedures are more easily performed but the recurrence rate of pain is higher. It is difficult to compare the results of surgical procedures reported by different authors. Therefore, we compare the efficacy of 155 microvascular decompressions with 113 radiofrequency thermocoagulations and 215 percutaneous microcompressions performed by the same surgical team. Our study confirms microvascular decompression as the most effective surgical treatment, although percutaneous procedures play an important role in the treatment protocol and have to be offered to patients as a therapeutic option.