Chuanke Zhang1, Lei Mei2, Meiyan Xia3, Jieshi Shen1, Bing Huang4, Xiaodong Huang1. 1. Department of Pain Management, Shanghai Pudong Hospital, Fudan University Pudong Medical Center Shanghai, China. 2. Department of Infectious Diseases, Shanghai Pudong Hospital, Fudan University Pudong Medical Center Shanghai, China. 3. Department of Radiology, Shanghai Pudong Hospital, Fudan University Pudong Medical Center Shanghai, China. 4. Department of Pain Management, The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University Jiaxing, Zhejiang Province, China.
Abstract
OBJECTIVE: To compare the efficacy and safety of CT-guided radiofrequency therapy in the treatment of trigeminal neuralgia (TN) through foramen rotundus at different temperatures. METHODS: A total of 60 patients with TN in our hospital were selected and randomly divided into the control group and the observation group, with 30 cases in each group. CT or MRI was routinely performed before the operation to exclude intracranial space-occupying lesions. The round hole of both groups of patients was targeted under CT guidance. The puncture needle position and depth were determined according to CT images and radiofrequency electrical stimulation. The control group gradually increased the radiofrequency temperature to 75°C, and the observation group gradually increased to 90°C for damage treatment. Both groups of patients were treated with radiofrequency for 360 s. The clinical efficacy was evaluated by BNI classification criteria. At the same time, the visual analog scale (VAS) score, the total score of Pittsburgh sleep quality index (PSQI) and the incidence of complications were compared between the two groups. The Kaplan-Meier method in survival analysis was used to calculate the pain recurrence rate at 1 and 2 years after the operation. RESULTS: One week after the operation, there was no significant difference in the total effective rate between the two groups (χ2=0.089, P=0.766). After 2 months, the total effective rate of the observation group was higher than that of the control group (χ2=4.043, P=0.044). One day and one week after the operation, the VAS score of the observation group was higher than that of the control group (t=7.365, 6.269; P=0.007, 0.012), and the total score of PSQI was significantly higher than that of the control group (t=8.026, 5.447; P=0.002, 0.015). There was no significant difference in VAS score and PSQI total score between the two groups 1 month and 2 months after operation (P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Kaplan-Meier survival analysis was used to calculate the recurrence rate of pain at 1 and 2 years after operation. The recurrence rate of the observation group was significantly lower than that of the control group (χ2=4.219, 4.021; P=0.039, 0.044). CONCLUSION:CT-guided radiofrequency at 90°C through foramen rotundus is effective in the treatment of trigeminal neuralgia without increasing the incidence of complications. AJTR
RCT Entities:
OBJECTIVE: To compare the efficacy and safety of CT-guided radiofrequency therapy in the treatment of trigeminal neuralgia (TN) through foramen rotundus at different temperatures. METHODS: A total of 60 patients with TN in our hospital were selected and randomly divided into the control group and the observation group, with 30 cases in each group. CT or MRI was routinely performed before the operation to exclude intracranial space-occupying lesions. The round hole of both groups of patients was targeted under CT guidance. The puncture needle position and depth were determined according to CT images and radiofrequency electrical stimulation. The control group gradually increased the radiofrequency temperature to 75°C, and the observation group gradually increased to 90°C for damage treatment. Both groups of patients were treated with radiofrequency for 360 s. The clinical efficacy was evaluated by BNI classification criteria. At the same time, the visual analog scale (VAS) score, the total score of Pittsburgh sleep quality index (PSQI) and the incidence of complications were compared between the two groups. The Kaplan-Meier method in survival analysis was used to calculate the pain recurrence rate at 1 and 2 years after the operation. RESULTS: One week after the operation, there was no significant difference in the total effective rate between the two groups (χ2=0.089, P=0.766). After 2 months, the total effective rate of the observation group was higher than that of the control group (χ2=4.043, P=0.044). One day and one week after the operation, the VAS score of the observation group was higher than that of the control group (t=7.365, 6.269; P=0.007, 0.012), and the total score of PSQI was significantly higher than that of the control group (t=8.026, 5.447; P=0.002, 0.015). There was no significant difference in VAS score and PSQI total score between the two groups 1 month and 2 months after operation (P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Kaplan-Meier survival analysis was used to calculate the recurrence rate of pain at 1 and 2 years after operation. The recurrence rate of the observation group was significantly lower than that of the control group (χ2=4.219, 4.021; P=0.039, 0.044). CONCLUSION: CT-guided radiofrequency at 90°C through foramen rotundus is effective in the treatment of trigeminal neuralgia without increasing the incidence of complications. AJTR