Surgical treatment of primary trigeminal neuralgia: comparison of the effectiveness between MVD and MVD+PSR in a series of 210 patients.

摘要

AIM: To evaluate the effectiveness of microvascular-decompression (MVD) or MVD+partial-sensory-rhizotomy (PSR) on the treatment of primary trigeminal neuralgia (TN). MATERIAL and METHODS: 210 TN patients were retrospectively studied, among which there're 142 cases underwent MVD and 68 cases underwent MVD+PSR. RESULTS: In MVD group, pain vanished in 128, obviously relieved in 9, and 137 cases were profited from MVD. In 82 cases with a follow-up over 2 years, pain vanished in 74, pain sometime occurred in 5 which could be relieved by oral medicine, 3 cases could not be controlled effectively by medicine. In MVD+PSR group, pain completely vanished in 67 cases, not changed in 1 case. In 47 cases with a follow-up over 2 years, pain sometime occurred in 2 which could be relieved by carbamazepine, the others were completely pain-free. The short-term pain-free rate of MVD+PSR group was obviously higher than MVD group(P < 0.05), after a follow-up over 2 years, the former was still higher than the later, 95.7% and 90.2% respectively, without significant difference in statistics. CONCLUSION: MVD+PSR was obviously superior to MVD in completely eliminating pain in short-term period after operation, however, longer pain-free rate need even longer time to follow up. Identifying the responsible vascular exactly and handling it reasonably were key to both groups.