Objective

The purpose of this study was to evaluate the effectiveness and safety of retrosigmoid approach in treating older patients with trigeminal neuralgia (TN).

Methods

In this retrospective study, 49patients (65 and over, elderly group) and 85 patients (under 65, young group) underwent MVD, MVD + PSR or PSR for idiopathic TN from July 2009 to December 2018. The two groups were compared for immediate, long-term pain outcome and postoperative complications. All perioperative data were collected from medical records and telephone interviews. The pain outcomes were assessed with the Barrow Neurological Institute (BNI) pain score.

Results

The length of follow-up was 13.2 to 124.8 months. 91.8% of the elderly patients and 89.4% of the young patients achieve “Good” immediate pain outcome (BNI I-II), the proportion were 73.5% and 60.0%, respectively, in long-term pain outcome. No statistically significant differences existed in the immediate and long-term pain outcome between the elderly and young patients (P = 0.768 and P = 0.116, respectively). In the grouping analysis, whether in the pure MVD group or the PSR-related group, the immediate and long-term pain outcomes of elderly patients were not significantly different from those of younger patients. Meanwhile, there was no significant difference in the incidence of neurological and non-neurological complications between two groups.

Conclusions

Compared with young patients, the treatment for TN in elderly patients via retrosigmoid approach has the same favorable pain outcome. The safety of this procedure for elderly TN patients is similar to that in young patients.

中文翻译：

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乙状窦后入路神经外科治疗老年三叉神经痛的有效性和安全性

客观的

本研究的目的是评估乙状结肠后入路治疗老年三叉神经痛 (TN) 患者的有效性和安全性。

方法

本回顾性研究于 2009 年 7 月至 2018 年 12 月对 49 名患者（65 岁及以上，老年组）和 85 名患者（65 岁以下，年轻组）进行了 MVD、MVD + PSR 或 PSR 治疗特发性 TN 的患者，比较两组患者的即刻、长期疼痛结果和术后并发症。所有围手术期数据均来自医疗记录和电话采访。使用巴罗神经学研究所 (BNI) 疼痛评分评估疼痛结果。

结果

随访时间为 13.2 至 124.8 个月。91.8%的老年患者和89.4%的年轻患者达到“良好”的即刻疼痛结果（BNI I-II），在长期疼痛结果中的比例分别为73.5%和60.0%。老年和年轻患者的即刻和远期疼痛结果无统计学差异（分别为 P = 0.768 和 P = 0.116）。在分组分析中，无论是单纯MVD组还是PSR相关组，老年患者的即刻和远期疼痛结局与年轻患者均无显着差异。同时，两组神经系统和非神经系统并发症的发生率无显着差异。

结论

与年轻患者相比，通过乙状结肠后入路治疗老年患者的 TN 具有同样良好的疼痛效果。该手术对老年 TN 患者的安全性与年轻患者相似。