Results of Percutaneous Balloon Compression in Trigeminal Pain Syndromes.

Abstract:

OBJECTIVE:To investigate initial pain relief and subsequent recurrence after percutaneous balloon compression (PBC) and describe its association with the nature of trigeminal pain, previous procedures, or other clinical factors. METHODS:A total of 222 patients with medically refractory trigeminal pain treated with PBC at Mayo Clinic Florida between 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 postprocedural rate of pain recurrence and associations between patient characteristics and recurrence were studied. RESULTS:One hundred fifty-two patients had TN and 70 patients had atypical pain. At the last follow-up, 158 patients had excellent pain relief, 37 had good pain relief, 11 had fair pain relief, and 16 had poor pain relief. The median duration of follow-up was 31.1 months. Patients with atypical pain were less likely to have an excellent result compared with patients with typical pain (61.4% vs. 82.9%; P < 0.001). Recurrence was observed in 103 patients (46.4%) and was associated with previous procedures (hazard ratio, 1.658; 95% confidence interval, 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 pain-free at last follow-up. Patients with atypical pain have worse outcomes, and patients with previous procedures have a higher risk of recurrence. Repeat surgery does not decrease efficacy. We recommend conservative parameter selection at the initial procedure.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Grewal SS,Kerezoudis P,Garcia O,Quinones-Hinojosa A,Reimer R,Wharen RE

doi

10.1016/j.wneu.2018.03.111

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

e892-e899

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(18)30593-X

journal_volume

114

pub_type

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