Byvaltsev V A, Kalinin A A, Okoneshnikova A K, Egorov A V, Goloborodko V Y, Satardinova E E, Levina G Y, Biryuchkov M Y
Irkutsk State Medical University, 1 Krasnogo Vosstaniya str., Irkutsk 664003, Russian Federation, e mail:
Clinical Hospital «Russian Railways-Medicine», Irkutsk, 10 Botkina str., Irkutsk 664005, Russian Federation.
Adv Gerontol. 2020;33(6):1122-1129.
The aim of the study was to analyze the results of surgical treatment of primary trigeminal neuralgia using laser destruction of the sensitive root in elderly and senile patients. The results of treatment of 25 patients older than 65 years with conservative treatment-resistant trigeminal pain who underwent laser destruction of the sensitive trigeminal root (970 nm, 9 Hz and 3 W power in a total dose of 100 J) in the period from 2018-2019 were prospectively studied. The average follow-up was 12 months. As a result, a significant decrease in the intensity of pain on the scale of facial pain was found from 87 (83,5; 91,5) mm to 15,5 (12,5; 18,5) mm (p=0,002) in the long-term period. On average, 12 months after the operation, a significant improvement in the indicators of the physical and psychological components of health was revealed on the SF-36 questionnaire (p=0,02 and p=0,01, respectively). In the follow-up on the Macnab scale, predominantly excellent (n=23; 92%) and good (n=2; 8%) treatment results were noted. Registered 1 (4%) perioperative complication and 2 (8%) adverse effects of anesthesiology benefits. Thus, the use of laser denervation of the sensitive root in primary trigeminal neuralgia in elderly and senile patients can significantly reduce the level of preoperative pain and improve the quality of life, with low risks of adverse effects.
本研究的目的是分析老年和高龄患者原发性三叉神经痛采用激光毁损感觉根的手术治疗结果。对2018年至2019年期间25例年龄大于65岁、保守治疗无效的三叉神经痛患者进行前瞻性研究，这些患者接受了感觉三叉神经根的激光毁损（970nm，9Hz，功率3W，总剂量100J）。平均随访时间为12个月。结果显示，长期来看，面部疼痛量表上的疼痛强度从87（83.5；91.5）mm显著降至15.5（12.5；18.5）mm（p=0.002）。术后平均12个月时，SF-36问卷显示健康的身体和心理成分指标有显著改善（分别为p=0.02和p=0.01）。在Macnab量表随访中，主要观察到优（n=23；92%）和良（n=2；8%）的治疗结果。记录到1例（4%）围手术期并发症和2例（8%）麻醉相关不良反应。因此，在老年和高龄原发性三叉神经痛患者中使用激光毁损感觉根可显著降低术前疼痛水平并改善生活质量，且不良反应风险较低。
