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Updated: Jun 26, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
[Transposition technique of microvascular decompression for hemifacial spasm without using a brain retractor]
Taku Shigeno1, Junichiro Kumai, Hiroshi Horikawa
1Department of Neurosurgery, Kanto Rosai Hospital, 1-1 Kizuki Sumiyoshicho, Nakahara-ku, Kawasaki-shi, Kanagawa 211-8510, Japan.
A novel surgical technique effectively treated hemifacial spasm (HFS) by transposing the vertebral artery. This microvascular decompression method achieved complete symptom resolution in all patients.
Area of Science:
- Neurosurgery
- Vascular Surgery
Background:
- Hemifacial spasm (HFS) is often caused by vertebral artery compression.
- Current microvascular decompression techniques may face challenges with vertebral artery transposition.
Observation:
- A unique transposition technique using GORE-TEX tape was developed for vertebral artery compression in HFS.
- This method secured space between the artery and the root exit zone (REZ) without brain retractors.
Findings:
- Complete transposition of the vertebral artery was achieved in all patients.
- All patients experienced immediate and complete cure of HFS post-surgery.
- The technique facilitated an adequate surgical working space.
Implications:
- This surgical strategy offers a viable solution for vertebral artery transposition in HFS.
- The technique demonstrates the potential for overcoming surgical difficulties with skill and planning.
- Successful microvascular decompression can lead to complete HFS symptom resolution.
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