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Results of Percutaneous Balloon Compression in Trigeminal Pain Syndromes.
World Neurosurg. 2018 Mar 23;:
Authors: Grewal SS, Kerezoudis P, Garcia O, Quinones-Hinojosa A, Reimer R, Wharen RE
Abstract
OBJECTIVE: The primary aim of this study was to investigate initial pain relief and subsequent recurrence after percutaneous balloon compression (PBC), and describe its association with the nature of trigeminal pain, prior procedures, or other clinical factors.
METHODS: Two hundred twenty-two patients with medically refractory trigeminal pain treated at Mayo Clinic Florida with PBC between the years 1998 and 2017, were enrolled into this study. Patients were divided into those with typical trigeminal neuralgia (TN), and those with atypical trigeminal pain. The post-procedural rate of recurrence and associations between patient characteristics and recurrence of pain were studied.
RESULTS: One hundred fifty-two patients had TN, seventy patients had atypical pain. At last follow-up, with regard to pain relief, one hundred fifty-eight patients had excellent, thirty-seven good, eleven fair and sixteen poor pain relief. The median follow-up time was 31.1 months. Patients with atypical pain were less likely to have an excellent result when compared to patients with typical pain (61.4% vs. 82.9%; P<0.001). Recurrence was observed in one hundred and three patients (46.4%), and was associated with prior procedures (hazard ratio (HR) = 1.658, 95% confidence interval (CI): 1.09-2.49, P = 0.017). Other clinical factors were not significant.
CONCLUSIONS: Our study demonstrates the safety and efficacy of PBC with 88% of patients being pain free at last follow-up. Patients with atypical pain have worse outcomes and patients with prior procedures have a higher risk of recurrence. Repeat surgery does not decrease efficacy. We recommend conservative parameter selection at the initial procedure.
PMID: 29581020 [PubMed - as supplied by publisher]
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