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Treatment of redo-microvascular decompression or internal neurolysis plus microvascular decompression for recurrent trigeminal neuralgia: a review of long-term effectiveness and safety

OBJECTIVE: We examined the clinical characteristics and outcomes of patients with recurrent trigeminal neuralgia (TN) and assessed the long-term efficacy and safety of microvascular decompression (MVD) to treat typical recurrent TN. METHODS: We identified 3024 patients who underwent MVD for treatmen...

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Detalles Bibliográficos
Autores principales: Wang, Baisheng, Zhang, Li, Yu, Yanbing
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8905060/
https://www.ncbi.nlm.nih.gov/pubmed/35249412
http://dx.doi.org/10.1177/03000605221080721
Descripción
Sumario:OBJECTIVE: We examined the clinical characteristics and outcomes of patients with recurrent trigeminal neuralgia (TN) and assessed the long-term efficacy and safety of microvascular decompression (MVD) to treat typical recurrent TN. METHODS: We identified 3024 patients who underwent MVD for treatment of TN at the China-Japan Friendship Hospital from March 2009 to December 2020. We retrospectively analyzed the data and outcomes of 137 patients who underwent redo-MVD and 74 patients who did not undergo redo-MVD as the control group. These outcomes were evaluated using the Barrow Neurological Institute scoring system. RESULTS: Recurrence in 68 of the 137 patients was due to incomplete or absent decompression or new responsible vessels. To ensure thorough pain relief, redo-MVD should include decompression of both the trigeminal root entry zone and the peripheral nerve segments, where blood vessels can cause symptoms. Factors associated with reduced effectiveness of redo-MVD were no period of initial pain relief after the first MVD and a longer duration of symptoms before the first MVD. CONCLUSIONS: Redo-MVD should not be excluded as a treatment option for patients with refractory TN who develop recurrent pain after a first MVD procedure.