Percutaneous Radio-Frequency Rhizotomy For Recurrent Trigeminal Neuralgia After Failure Of Microvascular Decompression

摘要

Background: Trigeminal neuralgia (TN) is a pain syndrome having a great impact on quality of life. Percutaneous radiofrequencythermocoagulation (PRT) is the most common surgical procedure done for the treatment of TN. While microvasculardecompression (MVD) was always used for more sustained pain relief and less incidence of recurrence but it is not always meetpatient pain relief satisfaction. Hence, we aimed to evaluate the effectiveness of radiofrequency thermocoagulation rhizotomy onpatients with recurrent TN after MVD.Methodology: A prospective study of 20 consecutive cases of recurrent TN after MVD underwent PRT from March 2014 to July2017. Based on clinical outcome and follow up, a second session of PRF was offered if patient pain relief was unsatisfactory.Effective pain control was considered when excellent or good outcome was achieved. For poor pain outcome, a secondprocedure was offered and done.Results: Mean age was 50.50 ± 10.23 ranged from 32-57 years. Pain score after PRT dropped from 4.60 ± 0.50 to 1.40 ± 0.94.The pain outcome after the first PRT procedure showed that only 35% had poor outcome which required another procedure ofPRT, after which VAS dropped from 4.57 ± 0.54 to 2.00 ± 1.41 immediately while 10% of the study cohort had poor quality ofpain after the second procedure.Conclusion: Recurrence of TN is difficult to avoid regardless the choice of the procedure. The majority of patients had completeor near total pain relief. Reapplication of PRT for failed PRT for first time in such cases can achieve very good outcome for painrelief.