Neurosurgery Department, University Hospital Dr. Josep Trueta, Girona, Girona, Spain.
Neurosurgery Department, University Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
Neurosurg Rev. 2022 Feb;45(1):405-410. doi: 10.1007/s10143-021-01575-5. Epub 2021 Jun 5.
Percutaneous rhizotomy is a cornerstone of trigeminal neuralgia treatment. The procedure is classically performed under intermittent fluoroscopic guidance. While frameless navigation has been advanced to overcome potential difficulties and risks of the technique, literature on the subject is limited, and a gap between actual use and published series is likely. We have assessed all available studies of percutaneous rhizotomy of the trigeminal nerve performed under frameless navigation. Technical and clinical data that has been reviewed included clinical outcome, type of navigation employed, type of rhizotomy performed, types and rate of complications, operative time, cannulation time, and cannulation rate. Reports are heterogeneous, and most of these aspects have been inconsistently described. Comparisons with non-guided procedures are mostly indirect. While no obvious disadvantages are apparent when employing navigation, the ability to draw conclusions is nonetheless limited. Navigation appears as an inviting adjunct to trigeminal rhizotomy, but publication of longer, rigorously evaluated series would be welcomed.
经皮神经根切断术是治疗三叉神经痛的基石。该手术通常在间歇性荧光透视引导下进行。虽然无框架导航技术已被用于克服该技术的潜在困难和风险，但该领域的文献有限，实际应用与已发表的系列之间可能存在差距。我们评估了所有可获得的无框架导航下三叉神经根经皮切断术的研究。已审查的技术和临床数据包括临床结果、使用的导航类型、进行的神经根切断术类型、并发症的类型和发生率、手术时间、置管时间和置管率。报告存在异质性，并且大多数这些方面的描述不一致。与非引导程序的比较大多是间接的。虽然在使用导航时没有明显的缺点，但得出结论的能力仍然受到限制。导航似乎是三叉神经根切断术的一个有吸引力的辅助手段，但欢迎发布更长时间、经过严格评估的系列报告。
