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原发性三叉神经痛的微血管减压术:短期随访结果及预后因素

Microvascular decompression for primary trigeminal neuralgia : short-term follow-up results and prognostic factors.

作者信息

Tucer Bülent, Ekici Mehmet Ali, Demirel Serkan, Başarslan Seyit Kağan, Koç Rahmi Kemal, Güçlü Bülent

机构信息

Department of Neurosurgery, Erciyes University, Medical School, Kayseri, Turkey.

出版信息

J Korean Neurosurg Soc. 2012 Jul;52(1):42-7. doi: 10.3340/jkns.2012.52.1.42. Epub 2012 Jul 31.

Abstract

OBJECTIVE

The aim of this prospective study was to demonstrate the influence of some factors on the prognosis of microvascular decompression in 37 patients with trigeminal neuralgia.

METHODS

The results of microvascular decompression (MVD) in 37 patients with trigeminal neuralgia were evaluated at 6 months after surgery and were compared with clinical and operative findings.

RESULTS

The sex of the patient, the patient's age at surgery, the side of the pain, and the duration of symptoms before surgery did not play any significant roles in prognosis. Also, the visual analogue scale (VAS) of the patient, the duration of each pain attack, and the frequency of pain over 24 hours did not play any significant roles in prognosis. In addition, intraoperative detection of the type of conflicting vessel, the degree of severity of conflict, and the location of the conflict around the circumference of the root did not play any roles in prognosis. The only factors affecting the prognosis in MVD surgery were intraoperative detection of the site of the conflict along the root and neuroradiological compression signs on preoperative magnetic resonance imaging (MRI)/magnetic resonance angiography (MRA).

CONCLUSION

These findings demonstrated that if neurovascular compression is seen on preoperative MRI/MRA and/or compression is found intraoperative at the root entry zone, then the patient will most likely benefit from MVD surgery.

摘要

目的

本前瞻性研究旨在探讨某些因素对37例三叉神经痛患者微血管减压术预后的影响。

方法

对37例三叉神经痛患者微血管减压术(MVD)的结果在术后6个月进行评估,并与临床及手术发现进行比较。

结果

患者的性别、手术时年龄、疼痛部位及术前症状持续时间对预后无显著影响。此外,患者的视觉模拟评分(VAS)、每次疼痛发作持续时间及24小时内疼痛频率对预后也无显著影响。另外,术中检测到的冲突血管类型、冲突严重程度及神经根周围冲突部位对预后均无影响。MVD手术中影响预后的唯一因素是术中检测到神经根上的冲突部位以及术前磁共振成像(MRI)/磁共振血管造影(MRA)上的神经放射学压迫征象。

结论

这些发现表明,如果术前MRI/MRA显示神经血管受压和/或术中在神经根入区发现受压,那么患者很可能从MVD手术中获益。

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