Factors Predicting Successful Outcomes for Percutaneous Radiofrequency Thermocoagulation in Patients With Idiopathic Trigeminal Neuralgia: Implications for Surgical Decision Making.

OBJECTIVES

In this study we aimed to identify specific factors predicting successful outcomes after percutaneous radiofrequency thermocoagulation (RFT) for idiopathic trigeminal neuralgia (ITN) and risk factors that were associated with inferior outcomes.

METHODS

We retrospectively reviewed our cohort of 1,624 patients who underwent RFT for trigeminal neuralgia between January 2000 and December 2017. Demographic and clinical data including age, gender, disease duration, affected side, baseline pain score, pain distribution, history of previous surgical intervention, and pain characteristics were collected and evaluated for their association with outcome using univariate and multivariate logistic regression analysis.

RESULTS

78.1% of patients experienced a successful outcome of RFT for ITN as predefined criteria. Pain characteristics and history of surgical treatment were significant predictors associated with successful outcomes in regression analysis. Multivariate analysis identified provoked episodic pain at diagnosis (odds ratio [OR] = 23.629, 95% confidence interval [CI]: 16.316 to 34.219, P = 0.010), mixed pain (OR = 8.394, 95% CI: 5.951 to 11.840, P = 0.011), and no history of surgical treatment (OR = 2.189, 95% CI: 1.411 to 3.396, P = 0.019) as independent predictors for successful RFT outcome.

CONCLUSION

Presence of provoked episodic pain and mixed pain were significantly associated with successful outcome of RFT for ITN. Moreover, patients with ITN who underwent RFT for the first time were more likely to benefit from successful outcome. These findings should be considered when managing ITN with RFT to improve the likelihood of a successful outcome.