Bui Van Giang, Nguyen Khac Dung, Nguyen Tran Canh, Pham Hong Duc, Nguyen Xuan Hung
Department of Radiology, International Vinmec Hospital, Hanoi, Viet Nam.
College of Health Sciences, VinUniversity, Hanoi, Viet Nam.
Interv Pain Med. 2023 Dec 14;2(4):100372. doi: 10.1016/j.inpm.2023.100372. eCollection 2023 Dec.
Percutaneous rhizotomy is a group of techniques used to treat trigeminal neuralgia. Radiofrequency thermocoagulation (RF) and Chemical Rhizotomy (CR) using glycerol are among the most frequently used methods. We have recently refined Ethanol Rhizotomy (ER) under Digital Subtraction Angiography (DSA) guidance.
A descriptive, retrospective study was conducted to compare our refined ER and RF ablation in patients with trigeminal neuralgia in terms of long-term pain relief and side effects.
Between 2012 and 2014, 33 patients with typical trigeminal neuralgia were enrolled, 10 of whom received RF and 23 received ER under (DSA) guidance with ethanol injected while in the supine position. The pain relief, duration of pain-free period, need for repeat injection, and recurrence of pain were recorded together with procedure-related complications within 7 years after the procedures.
After a single intervention or, in some cases, a maximum of two repeated interventions, all 33 patients experienced complete pain relief. Nevertheless, following a single procedure, the success rate was 95.6% (22/23) in the ER group and 60% (6/10) in the RF group. Notably, complete numbness was the most significant side effect, with a higher incidence in the ER group (30.4%) compared to the RF group (0%) (p = 0.02). The recurrence rate was statistically different (p = 0.01) between the two groups, with 4.4% and 40% recorded in the ER and RF groups, respectively.
We demonstrated the usefulness of our refined ER procedure as a safe, cost-effective, and efficient second-line treatment for TN.
经皮神经根切断术是一组用于治疗三叉神经痛的技术。射频热凝术（RF）和使用甘油的化学神经根切断术（CR）是最常用的方法。我们最近在数字减影血管造影（DSA）引导下改进了乙醇神经根切断术（ER）。
进行一项描述性回顾性研究，比较我们改进的ER和RF消融术在三叉神经痛患者中的长期疼痛缓解情况和副作用。
2012年至2014年，纳入33例典型三叉神经痛患者，其中10例接受RF治疗，23例在DSA引导下接受ER治疗，患者仰卧位时注射乙醇。记录疼痛缓解情况、无痛期持续时间、重复注射需求、疼痛复发情况以及术后7年内与手术相关的并发症。
经过单次干预，或在某些情况下最多两次重复干预后，所有33例患者均实现了完全疼痛缓解。然而，单次手术后，ER组的成功率为95.6%（22/23），RF组为60%（6/10）。值得注意的是，完全麻木是最显著的副作用，ER组的发生率（30.4%）高于RF组（0%）（p = 0.02）。两组的复发率在统计学上存在差异（p = 0.01），ER组和RF组分别为4.4%和40%。
我们证明了改进的ER手术作为三叉神经痛安全、经济高效的二线治疗方法的有效性。
