Barbagli G, Aglan O, Hussein A, Soto-Rubio D, Pacheco-Barrios N, Li C, Al-Arfaj A, Kelbert J, Dholaria N, Pico A, Deaver C M, Alhalal I, Prim M, Baaj A A
Department of Neurosurgery, University of Arizona College of Medicine, 1111 Mc Dowell Road, Phoenix, AZ, 85006, USA.
Eur Spine J. 2025 Feb;34(2):707-718. doi: 10.1007/s00586-024-08614-x. Epub 2025 Jan 10.
An atypical presentation of cervical spondylopathy (CS), trigeminal neuralgia (TN) is attributable to the extension of trigeminal nuclei into the spinal cord and is frequently overlooked, leading to limited discussion with patients regarding potential anterior cervical surgery. Our systematic review assesses the effectiveness of cervical surgery for concurrent trigeminal neuralgia in cases of cervical spondylopathy.
A systematic review exploring cases of trigeminal neuralgia related to cervical spondylopathy was conducted searching on PubMed, Scopus and Embase databases for article in English. The authors excluded literature reviews and paediatric studies. Abstracts from articles were initially screened, followed by a detailed review of full-text papers. We included studies that documented cases of trigeminal neuralgia unrelated to cranial pathologies in patients with cervical spondylopathy.
Following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol, 6 studies were included covering 30 patients (20 male, 10 female) with a mean age of 60.75 years and average symptom duration was 18 months. The most affected branches were V2 (41%) and V3 (49%), evenly distributed between left and right sides (55% vs 45%). Motor weakness (60%) and paresthesia (27%) were common non-trigeminal symptoms. The predominant compression levels were C2-C3 (38%) and C3-C4 (34%). After anterior cervical surgery (30% of patients), 100% experienced immediate resolution of trigeminal neuralgia, with no recrudescence at an average 7-month follow-up.
Besides common manifestations, high cervical stenosis can cause trigeminal neuralgia. This case report and systematic review confirms spinal decompression and fusion surgery may be effective in select cases. Surgeons should raise the possibility of cervical spine involvement when counseling patients with this disease.
作为颈椎病（CS）的一种非典型表现，三叉神经痛（TN）是由于三叉神经核延伸至脊髓所致，常被忽视，导致与患者关于潜在颈椎前路手术的讨论有限。我们的系统评价评估了颈椎病并发三叉神经痛时颈椎手术的有效性。
进行一项系统评价，探讨与颈椎病相关的三叉神经痛病例，在PubMed、Scopus和Embase数据库中检索英文文章。作者排除了文献综述和儿科研究。首先筛选文章摘要，然后对全文进行详细 review。我们纳入了记录颈椎病患者中与颅部病变无关的三叉神经痛病例的研究。
按照PRISMA（系统评价和Meta分析的首选报告项目）方案，纳入了6项研究，涵盖30例患者（男性20例，女性10例），平均年龄60.75岁，平均症状持续时间为18个月。受影响最严重的分支是V2（41%）和V3（49%），在左右两侧分布均匀（55%对45%）。运动无力（60%）和感觉异常（27%）是常见的非三叉神经症状。主要压迫节段为C2 - C3（38%）和C3 - C4（34%）。在前路颈椎手术后（30%的患者），100%的患者三叉神经痛立即缓解，平均7个月随访时无复发。
除常见表现外，高位颈椎狭窄可导致三叉神经痛。本病例报告和系统评价证实，在某些病例中，脊柱减压融合手术可能有效。外科医生在为患有这种疾病的患者提供咨询时应提高颈椎受累的可能性。
