Percutaneous Procedures for the Treatment of Trigeminal Neuralgia.
Three major percutaneous procedures are currently used to treat trigeminal neuralgia (TN). Percutaneous balloon compression, glycerol rhizotomy, and radiofrequency thermocoagulation interrupt afferent pain fibers by injury to the trigeminal nerve root or ganglion. Each is capable of offering immediate and durable pain relief. Each is associated with relatively low, but variable rates of complications. Patient heterogeneity, technical variation, and nonstandard outcomes plague the existing outcomes literature and limit comparisons of treatments. Rendering treatment selection a function of individual physician preference and practice patterns. Randomized, prospective trials are needed; in the meantime, percutaneous rhizotomy remains an excellent treatment for selected patients.
Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 118, Baltimore, MD 21287, USA.
Joanna Y
JY
Wang
Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 118, Baltimore, MD 21287, USA.
Matthew T
MT
Bender
Department of Neurosurgery, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 118, Baltimore, MD 21287, USA. Electronic address: cbetteg1@jhmi.edu.
Chetan
Ch
Bettegowda
D004564:Electrocoagulation / Q000379:methods*; D006801:Humans; D019051:Rhizotomy / Q000379:methods*; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000601:surgery*; D014277:Trigeminal Neuralgia / Q000601:surgery*
Rhizotomy; Treatment; Trigeminal neuralgia