title: Long term efficacy and patient satisfaction of microvascular decompression and gamma knife radiosurgery for trigeminal neuralgia.
abstract: The aim of our study was to evaluate the long term efficacy of microvascular decompression (MVD) and gamma knife radiosurgery (GKRS) with respect to pain relief and patient satisfaction. Both these modalities are accepted modalities of treatment for intractable trigeminal neuralgia. We excluded deceased patients, those who had a prior intervention and those requiring an additional intervention following initial treatment. A total of 69 patients were included in the study. Of these, 49 patients underwent treatment by GKRS and 20 by MVD. Pain status was assessed using the Barrow Neurological Institute (BNI) pain scale. The median follow up was 5.3years. There was no significant difference between the two groups with respect to initial pain relief (100% MVD, 84% GKRS; p=0.055). There was no significant difference in pain recurrence between the two groups (39% GKRS, 20% MVD; p=0.133). At last follow up, 85% of patients who underwent MVD had total pain relief (BNI scale I) compared to only 45% of GKRS patients (p=0.002). There was no significant difference in the patient satisfaction with respect to undergoing the same procedure again (90% MVD, 69% GKRS; p=0.1) and recommending it to family members (95% MVD, 84% GKRS; p=0.2). MVD offered total pain relief in a significantly higher number of patients than GKRS. There was no significant difference in the patient satisfaction rate between the two groups.
authors.affiliation: Department of Neurosurgery, Louisiana State Health Sciences Center, Post Office Box 33932, 1501 Kings Highway, Shreveport, LA 71130-3932, USA. Electronic address: ananda@lsuhsc.edu.
authors.forename: Anil
authors.initials: A
authors.lastname: Nanda
authors.affiliation: Department of Neurosurgery, Louisiana State Health Sciences Center, Post Office Box 33932, 1501 Kings Highway, Shreveport, LA 71130-3932, USA.
authors.forename: Vijayakumar
authors.initials: V
authors.lastname: Javalkar
authors.affiliation: Department of Neurosurgery, Louisiana State Health Sciences Center, Post Office Box 33932, 1501 Kings Highway, Shreveport, LA 71130-3932, USA.
authors.forename: Shihao
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Louisiana State Health Sciences Center, Post Office Box 33932, 1501 Kings Highway, Shreveport, LA 71130-3932, USA.
authors.forename: Osama
authors.initials: O
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D061145:Microvascular Decompression Surgery / Q000379:methods / Q000639:trends*; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D017060:Patient Satisfaction; D016634:Radiosurgery / Q000379:methods / Q000639:trends*; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*
keywords: Long term outcomes; Microvascular decompression; Patient satisfaction; Radiosurgery; Trigeminal neuralgia