Trigeminal neuralgia (TN) caused by vertebrobasilar artery (VBA) compression is a rare event, reported between 2 and 6% (Linskey et al. J Neurosurg 81:1-9,1992, Vanaclocha et al.World Neurosurg 96:516-529,2016) of the time. Microvascular decompression (MVD) is advised for drug-resistant pain and, although technically challenging, is associated with an excellent outcome in current literature (Apra et al.Neurosurg Rev 40:577-582,2017, Cruccuet al. EurJ Neurol 15:1013-1028,2008, Linskey et al. J Neurosurg 81:1-9,1992). The authors performed a systematic review and meta-analysis of the literature examining the rate of MVD for trigeminal neuralgia caused by VBA compression and the post-operative outcome. The systematic search of three databases was performed for studies published between January 1990 and October 2020. Random-effects meta-analysis was used to pool the analyzed outcomes, and random-effects meta-regression was used to examine the association between the effect size and potential confounders. Funnel plot followed by Egger’s linear regression was used to test publication bias. We included 9 studies, and the overall rate of TN due to VBA compression was 3.4% (95% CI 2.5–4.3%, p < 0.01, I² = 67.9%) among all MVD for TN. Immediately after surgery, 96% (p < 0.01, I² = 0%) of patients were pain-free, and at last follow-up, approximately 93% (p < 0.01, I² = 0%) of patients were classified as BNI I–II. Hearing impairment and facial numbness were the most common long-term complications ensuing MVD for VBA compression (5% and 13%, respectively). In conclusion, the surgical management of trigeminal neuralgia caused by VBA compression is associated with good outcome and low rate of post-operative complications. Further studies are needed to analyze the long-term results and the rate of pain recurrence among this population.

由椎基底动脉 (VBA) 压迫引起的三叉神经痛 (TN) 是一种罕见的事件，据报道为 2% 至 6% (Linskey et al. J Neurosurg 81:1-9,1992, Vanaclocha et al.World Neurosurg 96:516-529 ,2016) 的时间。微血管减压术 (MVD) 被推荐用于耐药性疼痛，虽然在技术上具有挑战性，但在当前文献中与极好的结果相关（Apra et al.Neurosurg Rev 40:577-582,2017, Cruccuet al. EurJ Neurol 15:1013 -1028,2008, Linskey et al. J Neurosurg 81:1-9,1992)。作者对有关 VBA 压迫引起的三叉神经痛的 MVD 发生率和术后结果的文献进行了系统回顾和荟萃分析。对 1990 年 1 月至 2020 年 10 月期间发表的研究进行了三个数据库的系统搜索。随机效应荟萃分析用于汇总分析结果，随机效应荟萃回归用于检查效应大小和潜在混杂因素之间的关联。漏斗图和 Egger 线性回归用于检验发表偏倚。我们纳入了 9 项研究，由于 VBA 压迫导致的 TN 总发生率为 3.4%（95% CI 2.5-4.3%，p  < 0.01, I ²  = 67.9%) 在 TN 的所有 MVD 中。术后即刻，96% ( p  < 0.01, I ²  = 0%) 的患者无痛，在最后一次随访中，大约 93% ( p  < 0.01, I ²  = 0%) 的患者被归类为BNI I-II。听力障碍和面部麻木是 VBA 加压 MVD 后最常见的长期并发症（分别为 5% 和 13%）。总之，VBA压迫引起的三叉神经痛的手术治疗效果好，术后并发症发生率低。需要进一步的研究来分析该人群的长期结果和疼痛复发率。