Combination of Pulsed Radiofrequency with Continuous Radiofrequency Thermocoagulation at Low Temperature Improves Efficacy and Safety in V2/V3 Primary Trigeminal Neuralgia

摘要

Background: Primary trigeminal neuralgia (TN) is a common clinical refractory neuralgia. Severepain is experienced during episodes, severely impacting the patient’s quality of life. Long-termsuffering from the disease can lead to anxiety, depression, and even suicide. The pathologicalprocesses involved in TN are complex, the mechanisms of pathogenesis are unknown, and effectivetreatment is lacking.Objective: This study aimed to assess the efficacy and safety of computed tomography (CT)-guided pulsed radiofrequency (PRF) combined with low-temperature continuous radiofrequency(CRF) thermocoagulation in V2/V3 primary trigeminal neuralgia.Study Design: This research used a retrospective comparative study design.Setting: The research took place at Shengjing Hospital of China Medical University.Methods: A total of 80 hospitalized patients with TN were selected between January 2014 andDecember 2015 and randomly assigned to 2 groups differentiated by therapeutic method: CRF(CRF group, n = 40) and PRF + CRF (PCRF group, n = 40). Radiofrequency therapy was performedunder the guidance of CT. Follow-up measures assessed preoperative conditions, pain remission,complications and side effects, recovery time, and recurrence rate over the 2 years following thesurgery.Results: The Visual Analog Scale (VAS) scores decreased in both groups after surgery. After onemonth, the decrease in the VAS score in the PCRF group was more apparent, and this differencewas maintained for 2 years. The total efficiency rates in the CRF and PCRF groups were 85% and97.5%, respectively, at 6 months, 1 year, and 2 years post-surgery. The differences in total efficiencyrate of pain between the 2 groups at 6 months, 1 year, and 2 years were statistically significant.Recovery times in the PCRF group were shorter than those in the CRF group. Specifically, recoverytimes for facial numbness in the CRF and PCRF groups were 3.12 ± 1.21 months and 2.23 ± 1.02months, respectively. Recovery times for masticatory muscle weakness were 4.33 ± 1.54 monthsand 3.42 ± 0.98 months, respectively.Limitations: This study is limited by being a retrospective study, and by having a relatively smallsample size from a single center.Conclusions: CT-guided PRF combined with low-temperature CRF thermocoagulation fortreating V2/V3 primary TN effectively relieves pain, increases late-stage pain remission rate, reducescomplications, and reduces the rate of recurrence.