Menna Grazia, Rapisarda Alessandro, Izzo Alessandro, D'Ercole Manuela, D'Alessandris Quintino Giorgio, Olivi Alessandro, Montano Nicola
Department of Neuroscience, Neurosurgery Section, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Brain Sci. 2022 Sep 9;12(9):1216. doi: 10.3390/brainsci12091216.
Microvascular decompression (MVD) is the only etiological technique for the treatment of trigeminal neuralgia (TN). Whilst there is a consensus MVD is likely effective regardless of age, the elderly population is thought to be more prone to have a higher rate of surgical complication, morbidity, and mortality. The main objective of our single-center, retrospective study was to analyze the surgical and clinical outcomes of MVD in TN elderly patients. From a surgical series of patients with TN who had undergone MVD from April 2018 to April 2022, 76 patients who matched the inclusion criteria were divided into two groups: twenty-five (32.9%) patients were older than 65 years and included in the elderly group, while the remaining fifty-one (61.1%) patients were below 65 years included in the non-elderly one. There were no differences between the groups in terms of acute pain relief (APR), Barrow Neurological Index (BNI) at follow-up, complications, and recurrence rate. In multivariate analysis (Cox proportional hazards regression analysis) the presence of an offending artery with nerve root distortion/indentation emerged as the only independent prognostic factor for pain-free survival ( = 0.0001). Our data endorse MVD as a safe and effective surgical procedure also for elderly patients with TN.
微血管减压术（MVD）是治疗三叉神经痛（TN）的唯一病因治疗技术。虽然人们一致认为，无论年龄大小，MVD可能都是有效的，但老年人群被认为更容易出现较高的手术并发症、发病率和死亡率。我们这项单中心回顾性研究的主要目的是分析MVD治疗老年TN患者的手术和临床结果。在2018年4月至2022年4月接受MVD治疗的TN患者手术系列中，76例符合纳入标准的患者被分为两组：25例（32.9%）年龄大于65岁，纳入老年组，其余51例（61.1%）年龄小于65岁，纳入非老年组。两组在急性疼痛缓解（APR）、随访时的巴罗神经学指数（BNI）、并发症和复发率方面没有差异。在多变量分析（Cox比例风险回归分析）中，存在导致神经根扭曲/压迹的责任动脉是无疼痛生存的唯一独立预后因素（P = 0.0001）。我们的数据支持MVD对于老年TN患者也是一种安全有效的外科手术。
