Microvascular decompression for trigeminal neuralgia in elderly patients.
OBJECTIVE
Although microvascular decompression (MVD) for patients with medically refractory trigeminal neuralgia (TN) is widely accepted as the treatment of choice, other "second-tier" treatments are frequently offered to elderly patients due to concerns regarding fitness for surgery. The authors sought to determine the safety and effectiveness of MVD for TN in patients older than 75 years of age.


METHODS
The authors performed a retrospective review of medical records and conducted follow-up telephone interviews with the patients. The outcome data from 25 MVD operations for TN performed in 25 patients with a mean age of 79.4 years (range 75-88 years) were compared with those of a control group of 25 younger patients with a mean age of 42.3 years (range 17-50 years) who underwent MVDs during the same 30-month period from July 2000 to December 2003.


RESULTS
Initial pain relief was achieved in 96% of the patients in both groups (p = 1.0). There were no operative deaths in either group. After an average follow-up period of 44 and 52 months, 78 and 72% of patients in the elderly and control groups, respectively, remained pain free without medication (p = 0.74).


CONCLUSIONS
Microvascular decompression is an effective treatment for elderly patients with TN. The authors' experience suggests that the rate of complications and death after MVD for TN in elderly patients is no different from the rate in younger patients.
Sekula
Raymond F
RF
Jannetta Center for Cranial Nerve Disorders, Department of Neurosurgery, Allegheny, General Hospital, Pittsburgh, Pennsylvania 15212, USA. rsekula@wpahs.org
Marchan
Edward M
EM
Fletcher
Lynn H
LH
Casey
Kenneth F
KF
Jannetta
Peter J
PJ
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000150:complications / Q000601:surgery*