Percutaneous microballoon compression assisted by neuronavigation and Hartel puncture for patients with trigeminal neuralgia
Objective To explore the application of neuronavigation-and Hartel puncture-assisted percutaneous microballoon compression(PMC)in patients with trigeminal neuralgia.Methods Eighty-two patients with primary trigeminal neuralgia to be treated with percutaneous balloon compression at First Hospital,Xi'an Jiaotong University from January 2018 to December 2020 were selected for the study,and were divided into a study group(40 cases)and a control group(42 cases)according to their treatment methods.There were 13 males and 27 females in the study group;they were(60.30±7.10)years old;their body mass index was(21.75±3.27)kg/m2;their disease course was(6.22±1.37)years;13 cases had trigeminal neuralgia on their left limbs,and 27 cases their right limbs;there were 3 cases with the pain branch of type Ⅱ,7 cases type Ⅲ,24 cases types Ⅱ+Ⅲ,4 cases types Ⅰ+Ⅱ,and 2 cases types Ⅰ+Ⅱ+Ⅲ.There were 16 males and 26 females in the study group;they were(59.85±6.22)years old;their body mass index was(22.19±3.10)kg/m2;their disease course was(6.50±1.19)years;14 cases had trigeminal neuralgia on their left limbs,and 28 cases their right limbs;there were 4 cases with the pain branch of type Ⅱ,8 cases type Ⅲ,26 cases types Ⅱ+Ⅲ,3 cases types Ⅰ+Ⅱ,and 1 case types Ⅰ+Ⅱ+Ⅲ.The control group took Hartel puncture-assisted PMC,and the study group neuronavigation-assisted PMC.The puncture,analgesic efficacies,operation times,hospitalization times,hospitalization costs,incidences of postoperative complications,and scores of Visual Analogue Scale(VAS)before and 1 d,1 month,6 months,1 year,and 2 years after the surgery were compared between the two groups by t test,x2 test,repeated measurement analysis of variance,and Mann-Whitney U test.Results The successful puncture rates in both groups were 100％.There was no statistical difference in the puncture times between the two groups(P＞0.05).The successful puncture rate at the first time in the study group was higher than that in the control group[90.00％(36/40)vs.71.43％(30/42)],with a statistical difference(P＜0.05).The scores of VAS 1 d,1 month,6 months,1 year,and 2 years after the surgery in both groups were lower than those before the surgery(all P＜0.05).The score of VAS 1 d after the surgery in the study group was lower than that in the control group[(0.31±0.11)vs.(0.37±0.10);P＜0.05].There were no statistical differences in the scores of VAS 1 month,6 months,1 year,and 2 years after the surgery between the two groups(all P＞0.05).There were no statistical differences in the analgesic efficacies 1 d,1 month,6 months,1 year,and 2 years after the surgery between the two groups(all P＞0.05).The operation time in the study group were longer than that in the control group[(36.27±4.78)min vs.(15.60±5.69)min;P＜0.05].The hospitalization cost in the study group was higher than that in the control group[(17 000±2 000)yuan vs.(13 600±2 400)yuan;P＜0.05].There was no statistical difference in the hospitalization time between the two groups(P＞0.05).There were no statistical differences in the incidences of postoperative facial numbness,subcutaneous hematoma,herpes zoster of the mouth and lips,and biting muscle weakness between the two groups(all P＞0.05).No serious complications,such as diplopia,corneal ulcer,cerebral infarction,cerebral hemorrhage,cerebrospinal fluid leakage,etc.,occurred in both groups during the follow-up period.Conclusions The long-term effects of neuronavigation-and Hartel puncture-assisted PMC for patients with trigeminal neuralgia are similar;neuronavigation-assisted PMC has a higher successful puncture rate at the first time and better short-term effect,but longer operation time and higher hospitalization cost,so the patients can choose an appropriate surgical plan according to the actual clinical situation.
万方数据
维普
