Krzemińska Anastasija, Koźba-Gosztyła Marta, Bladowska Joanna, Czapiga Bogdan
Department of Neurosurgery, Wroclaw 4th Military Clinical Hospital, Wroclaw, Poland.
Faculty of Medicine, Wroclaw University of Science and Technology, Grunwaldzki square 11, Wrocław, 51-377, Poland.
Neurosurg Rev. 2025 Aug 21;48(1):614. doi: 10.1007/s10143-025-03772-y.
To evaluate the effectiveness, safety, and patient satisfaction associated with microvascular decompression (MVD) in the treatment of trigeminal neuralgia (TN), and to identify clinical and surgical factors associated with postoperative outcomes and TN recurrence.
This retrospective single-center study included 28 patients with TN who underwent MVD between 2018 and 2025. Data on demographics, TN subtype, preoperative imaging, prior treatments, surgical findings, use of Teflon suture, and complications were analyzed. Outcomes were assessed using the Barrow Neurological Institute (BNI) Pain Intensity Scale at early postoperative and follow-up stages. Kaplan-Meier survival analysis was used to assess pain-free intervals. Patient satisfaction was evaluated based on willingness to undergo the surgery again.
Classical TN was diagnosed in 75% of patients. Preoperative MRI correctly predicted the presence of a conflict in 20 of 26 patients who actually had one (76.9%). Immediate postoperative pain relief (BNI I-II) was achieved in 85.7% of patients, and recurrence occurred in 16.7% of initially pain-free individuals. The average pain-free period was 28.5 ± 29.4 months. The use of a Teflon suture did not significantly affect recurrence or outcome. Major complications occurred in 10.7% of cases and included CSF leak from the surgical wound, neuroinfection and hematoma. Patient satisfaction was high, with 82% stating they would choose to undergo MVD again. Better outcomes were significantly associated with classical TN subtype. No significant associations were found with age, sex, prior gamma knife therapy, or Teflon fixation technique.
in our cohort MVD was a highly effective and well-tolerated treatment for TN, particularly in classical cases, offering high rates of long-term pain relief and patient satisfaction. Complications were rare in our cohort. Outcomes were not influenced by Teflon suture use or demographic factors, supporting the role of MVD as a first-line surgical option in appropriate candidates.
Not applicable.
评估微血管减压术（MVD）治疗三叉神经痛（TN）的有效性、安全性及患者满意度，并确定与术后结果和TN复发相关的临床及手术因素。
这项回顾性单中心研究纳入了2018年至2025年间接受MVD治疗的28例TN患者。分析了人口统计学数据、TN亚型、术前影像学检查、既往治疗情况、手术发现、聚四氟乙烯缝线的使用及并发症。术后早期及随访阶段采用巴罗神经学研究所（BNI）疼痛强度量表评估结果。采用Kaplan-Meier生存分析评估无疼痛间隔时间。根据患者是否愿意再次接受手术评估患者满意度。
75%的患者被诊断为典型TN。术前MRI在实际存在冲突的26例患者中的20例（76.9%）中正确预测了冲突的存在。85.7%的患者术后立即实现疼痛缓解（BNI I-II级），16.7%最初无疼痛的个体出现复发。平均无疼痛期为28.5±29.4个月。聚四氟乙烯缝线的使用对复发或结果无显著影响。10.7%的病例发生主要并发症，包括手术伤口脑脊液漏、神经感染和血肿。患者满意度较高，82%的患者表示会选择再次接受MVD。较好的结果与典型TN亚型显著相关。未发现与年龄、性别、既往伽玛刀治疗或聚四氟乙烯固定技术有显著关联。
在我们的队列中，MVD是一种治疗TN的高效且耐受性良好的方法，尤其是在典型病例中，能提供较高的长期疼痛缓解率和患者满意度。我们队列中的并发症很少见。结果不受聚四氟乙烯缝线使用或人口统计学因素的影响，支持MVD作为合适候选者的一线手术选择的作用。
不适用。
