Klassen Peter D, Ivaturi Sai K, Hendricks Benjamin K
Neurosurgery, Bonifatius Hospital, Lingen, DEU.
Clinical Applications Engineering, Zap Surgical Systems, Inc., San Carlos, USA.
Cureus. 2022 May 12;14(5):e24951. doi: 10.7759/cureus.24951. eCollection 2022 May.
Characterized by intense, episodic lancinating pain within the distribution of the trigeminal nerve, trigeminal neuralgia (TN) is the most common craniofacial pain syndrome. Failure of medical management requires the consideration of interventional procedures. Stereotactic radiosurgery (SRS) is one of the more commonly used surgical options. Herein, we report the first published case of a patient with TN treated in the ZAP-X (San Carlos, CA: ZAP Surgical Systems, Inc.) gyroscopic radiosurgery system. This 59-year-old man with multiple sclerosis and recurrent intractable left idiopathic TN following previous SRS was retreated in the Zap-X system using 100 isocentric 5 mm beams to a dose of 7500 cGy. At a three-month follow-up, the patient reported a 45% decrease in his visual analogue scale (VAS) and a reduced need for medication. Albeit preliminary, this initial experience highlights the feasibility of a self-shielded, cobalt-free, device for radiosurgically treating TN.
三叉神经痛（TN）以三叉神经分布区域内强烈的发作性刺痛为特征，是最常见的颅面疼痛综合征。药物治疗无效时需要考虑介入治疗。立体定向放射外科（SRS）是较常用的手术选择之一。在此，我们报告首例在ZAP-X（加利福尼亚州圣卡洛斯：ZAP Surgical Systems公司）陀螺式放射外科系统中接受治疗的TN患者。这名59岁男性患有多发性硬化症，之前接受SRS后复发难治性左侧特发性TN，此次在Zap-X系统中使用100个等中心5毫米束，剂量为7500 cGy进行再次治疗。在三个月的随访中，患者报告其视觉模拟量表（VAS）下降了45%，对药物的需求减少。尽管这只是初步经验，但这一初始经验凸显了一种用于放射外科治疗TN的自屏蔽、无钴设备的可行性。
