Sindou M, Amrani F, Mertens P
Department of Neurosurgery, Hopital Neurologique, Lyon, France.
Acta Neurochir Suppl (Wien). 1991;52:127-9. doi: 10.1007/978-3-7091-9160-6_34.
The positive effect of Microsurgical Vascular Decompression (MVD) on idiopathic trigeminal neuralgia still remains controversial between a decompressive mechanism and a "neo-compressive" one. This paper is a summary of a comparative study of the results on pain obtained with two technical modifications of the MVD procedure. The first consisted of interposition of a foreign material between the nerve and the transposed artery after dissection of the trigeminal nerve, whilst in the second the offending vessel(s) was dislodged without using any material touching the nerve. The two series of 60 patients in each were similar concerning the clinical features. Evaluation of results on neuralgia - with one year follow-up-in both series, shows that the technique used in the second group was not followed by a higher rate of recurrence than the technique used in the first group. On the contrary; 4.5% in the 2nd group compared to 10% in the first. This indicates that MVD would not act as a result of "neo-compression" of the nerve, but rather through a real decompressive mechanism.
微血管减压术（MVD）对原发性三叉神经痛的积极作用在减压机制和“新压迫”机制之间仍存在争议。本文是一项对比研究的总结，该研究对比了MVD手术的两种技术改良所取得的疼痛治疗效果。第一种改良方法是在三叉神经解剖后，在神经与移位动脉之间置入异物；而第二种方法是在不使用任何接触神经的材料的情况下，将肇事血管移开。每组60例患者的两个系列在临床特征方面相似。对两个系列患者进行一年随访的神经痛结果评估显示，第二组所采用的技术的复发率并不高于第一组所采用的技术。相反，第二组为4.5%，而第一组为10%。这表明MVD并非通过对神经的“新压迫”起作用，而是通过真正的减压机制起作用。
