Department of Neurosurgery, Qingdao Municipal Hospital, No.1 Jiaozhou Rd, Qingdao City, 266000, China.
Department of Pathology, Tongji Hospital, Shanghai Tongji University, 389 Xincun Rd, Shanghai, 200092, China.
Neurosurg Rev. 2022 Feb;45(1):561-569. doi: 10.1007/s10143-021-01514-4. Epub 2021 May 24.
Because of its convenience and safety, percutaneous balloon compression (PBC) has become a more popular remedy for trigeminal neuralgia (TN) recently. The objective of this study was to establish a nomogram that can be used to preoperatively prognosticate the likelihood of pain-free based on preoperative disease characteristics. Clinical data were collected from those TN cases who had undergone PBC during the period of 2015 and 2020 in Qingdao Municipal Hospital. We excluded the cases caused by space-occupying lesion or had undergone MVD, percutaneous glycerol rhizotomy (PGR), and glycerol rhizotomy (GR). A nomogram was established based on the results of multivariable logistic analysis. A receiver operating characteristic curve (ROC) analysis was applied to evaluate the reliability of models. The plotted decision curves were also used to assess the net benefit of nomogram-assisted decisions. Internal validation was performed using the ROC by bootstrap sampling. Finally, 16 cases and 69 cases were included into the ineffective and effective groups respectively. In the crude, adjust I and adjust II models, response to carbamazepine positively, the grade II or III compression severity score, and classical TN type were all considered to be significant predictors of pain relief (BNI grades I-III) at 3 months' follow-up. The AUC, accuracy, specificity, and sensitivity of the nomogram system were 0.83, 0.85, 0.75, and 0.87 respectively for predicting patient outcomes. The decision curves showed good performance for the nomogram system in terms of clinical application, while more research with validation in multiple, external independent patient populations is needed.
由于其方便性和安全性，经皮球囊压迫术（PBC）最近已成为治疗三叉神经痛（TN）的一种更受欢迎的方法。本研究的目的是建立一个列线图，以便根据术前疾病特征预测术前无疼痛的可能性。我们从 2015 年至 2020 年在青岛市立医院接受 PBC 治疗的 TN 病例中收集了临床数据。我们排除了因占位性病变或已接受微血管减压术（MVD）、经皮甘油根切术（PGR）和甘油根切术（GR）治疗的病例。基于多变量逻辑分析的结果建立了列线图。应用受试者工作特征曲线（ROC）分析评估模型的可靠性。绘制决策曲线还用于评估列线图辅助决策的净效益。内部验证使用 ROC 通过 bootstrap 采样进行。最后，无效组和有效组分别纳入 16 例和 69 例。在原始、调整 I 和调整 II 模型中，卡马西平反应阳性、II 级或 III 级压缩严重程度评分和经典 TN 类型均被认为是 3 个月随访时疼痛缓解（BNI 分级 I-III）的显著预测因素。列线图系统的 AUC、准确性、特异性和敏感性分别为 0.83、0.85、0.75 和 0.87，用于预测患者结局。决策曲线表明，该列线图系统在临床应用方面具有良好的性能，但是需要更多的多中心、外部独立患者群体进行验证研究。
