Bick Sarah K B, Eskandar Emad N
Department of Neurosurgery, Massachusetts General Hospital, Their 4, 55 Fruit Street, Boston, MA 02114, USA.
Department of Neurosurgery, Massachusetts General Hospital, Their 4, 55 Fruit Street, Boston, MA 02114, USA.
Neurosurg Clin N Am. 2017 Jul;28(3):429-438. doi: 10.1016/j.nec.2017.02.009. Epub 2017 Mar 24.
Trigeminal neuralgia is characterized by severe, episodic pain in the trigeminal nerve distribution. Medical therapy is the first line treatment. For patients with refractory pain, a variety of procedures including microvascular decompression, percutaneous radiofrequency rhizotomy, percutaneous glycerol rhizotomy, percutaneous balloon compression, and stereotactic radiosurgery are available. We review the literature and suggest that microvascular decompression remains the gold standard operative therapy. For patients with recurrent pain or who are poor operative candidates, percutaneous radiofrequency rhizotomy offers the best pain response rates and has the advantage of being able to selectively target affected trigeminal divisions.
三叉神经痛的特点是三叉神经分布区域出现严重的发作性疼痛。药物治疗是一线治疗方法。对于顽固性疼痛患者，有多种治疗手段可供选择，包括微血管减压术、经皮射频神经根切断术、经皮甘油神经根切断术、经皮球囊压迫术和立体定向放射外科手术。我们回顾了相关文献并认为，微血管减压术仍是手术治疗的金标准。对于复发性疼痛患者或手术条件较差的患者，经皮射频神经根切断术的疼痛缓解率最佳，且能够选择性地针对受影响的三叉神经分支。
