OBJECTIVE: The aim of this study was to identify preoperative imaging predictors of surgical success in patients with classic trigeminal neuralgia (cTN) undergoing microvascular decompression (MVD) via retrospective multivariate regression analysis. METHODS: All included patients met criteria for cTN and underwent preoperative MRI prior to MVD. MR images were blindly graded regarding the presence and severity (i.e., mild or severe) of neurovascular compression (NVC). All patients were contacted by telephone to determine their postoperative pain status. RESULTS: A total of 79 patients were included in this study. Sixty-two patients (78.5%) were pain-free without medication following MVD. The following findings were more commonly observed with the symptomatic nerve when compared to the contralateral asymptomatic nerve: NVC (any form), arterial compression alone, NVC along the proximal trigeminal nerve, and severe NVC (p values < 0.0001). The only imaging variable that was a statistically significant predictor of being pain-free without medication following MVD was severe NVC. Patients with severe NVC were 6.36 times more likely to be pain-free following MVD compared to those without severe NVC (p = 0.007). CONCLUSIONS: In patients with cTN undergoing MVD, severe NVC on preoperative MRI is a strong predictor of an excellent surgical outcome.
OBJECTIVE: The aim of this study was to identify preoperative imaging predictors of surgical success in patients with classic trigeminal neuralgia (cTN) undergoing microvascular decompression (MVD) via retrospective multivariate regression analysis. METHODS: All included patients met criteria for cTN and underwent preoperative MRI prior to MVD. MR images were blindly graded regarding the presence and severity (i.e., mild or severe) of neurovascular compression (NVC). All patients were contacted by telephone to determine their postoperative pain status. RESULTS: A total of 79 patients were included in this study. Sixty-two patients (78.5%) were pain-free without medication following MVD. The following findings were more commonly observed with the symptomatic nerve when compared to the contralateral asymptomatic nerve: NVC (any form), arterial compression alone, NVC along the proximal trigeminal nerve, and severe NVC (p values < 0.0001). The only imaging variable that was a statistically significant predictor of being pain-free without medication following MVD was severe NVC. Patients with severe NVC were 6.36 times more likely to be pain-free following MVD compared to those without severe NVC (p = 0.007). CONCLUSIONS: In patients with cTN undergoing MVD, severe NVC on preoperative MRI is a strong predictor of an excellent surgical outcome.
Authors: Weilai Dong; Sheng Chih Jin; August Allocco; Xue Zeng; Amar H Sheth; Shreyas Panchagnula; Annie Castonguay; Louis-Étienne Lorenzo; Barira Islam; Geneviève Brindle; Karine Bachand; Jamie Hu; Agata Sularz; Jonathan Gaillard; Jungmin Choi; Ashley Dunbar; Carol Nelson-Williams; Emre Kiziltug; Charuta Gavankar Furey; Sierra Conine; Phan Q Duy; Adam J Kundishora; Erin Loring; Boyang Li; Qiongshi Lu; Geyu Zhou; Wei Liu; Xinyue Li; Michael C Sierant; Shrikant Mane; Christopher Castaldi; Francesc López-Giráldez; James R Knight; Raymond F Sekula; J Marc Simard; Emad N Eskandar; Christopher Gottschalk; Jennifer Moliterno; Murat Günel; Jason L Gerrard; Sulayman Dib-Hajj; Stephen G Waxman; Fred G Barker; Seth L Alper; Mohamed Chahine; Shozeb Haider; Yves De Koninck; Richard P Lifton; Kristopher T Kahle Journal: iScience Date: 2020-09-11