Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia: technique and expectations.
OBJECTIVE
In the management of trigeminal neuralgia (TN), physicians seek rapid and long-lasting pain relief, together with preservation of trigeminal nerve function. Percutaneous retrogasserian glycerol rhizotomy (PRGR) offers distinct advantages over other available procedures. The aim of this report was to provide details of the PRGR procedure and its expected outcome.


METHODS
The authors reviewed their experience with PRGR in 1174 patients to evaluate the procedural technique, results, and complications. Although it is clear that TN is not a static disorder but one characterized by remissions and recurrences, long-lasting pain relief was noted in 77% of patients, with 55% discontinuing all medications and 22% requiring some drug usage.


CONCLUSIONS
The authors discuss the role of PRGR in their practice, along with other procedures such as microvascular decompression and gamma knife surgery, for idiopathic or multiple sclerosis-related TN. They conclude that PRGR had distinct advantages over other procedures, which include eliminating the need for intraoperative confirmatory sensory testing, and a lower risk of facial sensory loss.
Kondziolka
Douglas
D
Department of Neurological Surgery and the Center for Image-Guided Neurosurgery, University of Pittsburgh, Pennsylvania, USA. kondzi-olkads@upmc.edu
Lunsford
L Dade
LD
D005990:Glycerol / Q000008:administration & dosage*; D006801:Humans; D019051:Rhizotomy / Q000379:methods*; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000473:pathology / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000473:pathology / Q000601:surgery*
D005990:Glycerol