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Microvascular Decompression for Trigeminal Neuralgia: A Prospective, Multicenter Study
Neurosurgery ( IF 4.8 ) Pub Date : 2021-07-29 , DOI: 10.1093/neuros/nyab229
Yoshifumi Mizobuchi 1 , Shinji Nagahiro 1 , Akinori Kondo 2 , Kazunori Arita 3 , Isao Date 4 , Yukihiko Fujii 5 , Takamitsu Fujimaki 6 , Ryosuke Hanaya 3 , Mitsuhiro Hasegawa 7 , Toru Hatayama 8 , Tooru Inoue 9 , Hidetoshi Kasuya 10 , Masahito Kobayashi 6 , Eiji Kohmura 11 , Toshio Matsushima 12 , Jun Masuoka 13 , Akio Morita 14 , Shigeru Nishizawa 15 , Yoshihiro Okayama 1 , Taku Shigeno 16 , Hiroshi Shimano 2 , Hideo Takeshima 17 , Iwao Yamakami 18
Affiliation  

Abstract
BACKGROUND
Microvascular decompression (MVD) is the most effective procedure for the long-term management of trigeminal neuralgia (TGN). However, retrospective and single-center studies are inherently biased, and there are currently no prospective, multicenter studies.
OBJECTIVE
To evaluate the short- and long-term outcomes and complications in patients with TGN who underwent MVD at specialized Japanese institutions.
METHODS
We enrolled patients with TGN who underwent MVD between April 2012 and March 2015. We recorded their facial pain grade and complications at 7 d (short term), 1 yr (mid-term), and 3 yr (long term) postoperatively.
RESULTS
There were 166 patients, comprising 60 men and 106 women (mean age 62.7 yr). Furthermore, 105 patients were aged over 60 yr. We conducted neuromonitoring in 84.3% of the cases. The complete pain relief, mortality, and complication rates at the short-term follow-up were 78.9%, 0%, and 16.3%, respectively. Overall, 155 patients (93.4%) completed the long-term follow-up, with the complete pain relief and complication rates of 80.0% and 5.2%, respectively.
CONCLUSION
In the hands of experienced neurosurgeons, MVD for TGN can achieve high long-term curative effects. In addition, complications are uncommon and usually transient. Our results indicate that MVD is an effective and safe treatment for patients with TGN, including elderly patients.


中文翻译:

三叉神经痛的微血管减压术:一项前瞻性、多中心研究

摘要
背景
微血管减压术 (MVD) 是长期治疗三叉神经痛 (TGN) 的最有效方法。然而,回顾性和单中心研究存在固有的偏倚,目前尚无前瞻性、多中心研究。
客观的
评估在日本专业机构接受 MVD 的 TGN 患者的短期和长期结果和并发症。
方法
我们招募了在 2012 年 4 月至 2015 年 3 月期间接受 MVD 的 TGN 患者。我们在术后 7 天(短期)、1 年(中期)和 3 年(长期)记录了他们的面部疼痛等级和并发症。
结果
共有 166 名患者,包括 60 名男性和 106 名女性(平均年龄 62.7 岁)。此外,105 名患者的年龄超过 60 岁。我们对 84.3% 的病例进行了神经监测。短期随访时疼痛完全缓解、死亡率和并发症发生率分别为 78.9%、0% 和 16.3%。总体而言,155 名患者(93.4%)完成了长期随访,疼痛完全缓解率和并发症发生率分别为 80.0% 和 5.2%。
结论
在经验丰富的神经外科医生手中,TGN 的 MVD 可以取得很高的远期疗效。此外,并发症并不常见,而且通常是短暂的。我们的结果表明,MVD 是一种有效且安全的治疗 TGN 患者(包括老年患者)的方法。
更新日期:2021-09-15
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