Efficacy observation of microscopic surgery in the treatment of recurrent trigeminal neuralgia after Gamma knife surgery
Objective To observe the feasibility and efficacy of microscopic surgery in treating recurrent trigeminal neuralgia(TN)after Gamma knife surgery.Methods A retrospective analysis was conducted on patients with recurrent TN who underwent microscopic surgery in the Neurosurgery Department of Wuxi Second People's Hospital from January 2010 to April 2021.Among the 19 patients included in the study,2 had initially received microvascular decompression(MVD)before undergoing nerve root decompression after Gamma knife treatment.Of the 17 patients primarily treated with Gamma knife surgery,4 underwent merely MVD,while 13 received MVD combined with nerve root decompression.The Barrow Neurological Institute(BNI)pain intensity score was utilized to evaluate the degree of pain relief,and surgical efficacy along with related complications were monitored.Results All 19 patients underwent successful surgery.During the perioperative period,14 patients achieved complete pain relief,4 experienced partial relief,and 1 had ineffective outcome.Among the patients with partial relief,3 had only undergone MVD.The average follow-up duration for the 19 patients was 63.9±13.9 months,ranging from 48 to 96 months.Among the 15 patients who underwent MVD combined with nerve root decompression,14 patients had no recurrence during the follow-up period,while 1 patient with partial relief experienced no change in the pain level.Of the 4 patients who underwent merely MVD,2 showed no significant changes,and both patients with partial relief experienced recurrence 8 months after surgery.Conclusions The use of microsurgical techniques to treat recurrent TN after Gamma knife surgery is feasible and associated with no serious surgery-related complications.The efficacy of patients who underwent only MVD is limited,and MVD combined with nerve root decompression could more effectively alleviate pain symptoms.
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