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Trigeminal Neuralgia: A Comparison of the Results of Percutaneous Rhizotomy and Microvascular Decompression

Published online by Cambridge University Press:  18 September 2015

G.G. Ferguson ,
D.C. Brett ,
S.J. Peerless ,
H.W.K. Barr  and
J.P. Girvin
G.G. Ferguson*
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
D.C. Brett
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
S.J. Peerless
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
H.W.K. Barr
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
J.P. Girvin
Affiliation:
Division of Neurosurgery, Department of Clinical Neurological Sciences, The University of Western Ontario, London, Canada
*
F.R.C.S. (C), University Hospital, P.O. Box 5339, Terminal “A”, London, Ontario, Canada, N6A 5A5
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Seventy-five patients were treated between March 1976 and June 1980 for classical idiopathic tic douloureux. Fifty-five patients underwent percutaneous trigeminal rhizotomy (PTR) and twenty-four had posterior fossa microvascular decompression (M VD) of the trigeminal nerve. Four patients had both procedures. In the PTR group. 4% were immediate failures, 42% had a delayed recurrence of pain, while 54% remained totally pain free with an average follow-up of 30 months. In the MVD group, 12% were immediate failures, 17% had a delayed recurrence of pain, and 71% have remained free of pain with an average follow-up of 28 months. Neither procedure can be regarded as ideal surgical treatment for patients with pain refractory to medical treatment. Percutaneous rhizotomy has an established place because of its safety, particularly in elderly patients. A high rate of recurrent pain is to be expected. Microvascular decompression has appeal in younger patients because of its non-destructive nature but the long term efficacy of the procedure is not known.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 8 , Issue 3 , August 1981 , pp. 207 - 214
Copyright
Copyright © Canadian Neurological Sciences Federation 1981

References

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