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Cyberknife Radiosurgery for Trigeminal Neuralgia
Pantaleo Romanelli1, Alfredo Conti2, Irene Redaelli3
1Neurosurgery, Cyberknife Center, Centro Diagnostico Italiano, Milano, ITA.
Cureus
|December 10, 2019
Summary
Robotic radiosurgery effectively treats trigeminal neuralgia (TN), offering significant pain relief for most patients. While repeat treatments can restore pain control, they increase the risk of facial numbness.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Medical Technology
Background:
- Trigeminal neuralgia (TN) is a debilitating neuropathic pain condition.
- Image-guided robotic radiosurgery presents a minimally invasive treatment option for drug-resistant TN.
- CyberKnife radiosurgery is increasingly utilized for TN management.
Purpose of the Study:
- To evaluate the long-term clinical outcomes of CyberKnife radiosurgery for trigeminal neuralgia.
- To assess pain control rates and the incidence of complications in a large patient cohort.
- To analyze the efficacy and safety of repeat radiosurgery treatments for recurrent TN.
Main Methods:
- Retrospective analysis of 387 CyberKnife radiosurgery treatments in 343 patients with TN.
- Dose prescription of 60 Gy (primary) and 45 Gy (retreatment) to the trigeminal nerve.
- Clinical outcomes including pain relief and facial hypoesthesia evaluated up to 36 months post-treatment.
Main Results:
- A sustained pain relief rate of 76% at 36 months was observed.
- The overall incidence of bothersome facial hypoesthesia was 6.1% at 36 months.
- Patients receiving repeat treatments had a higher rate of sensory complications (18/21).
Conclusions:
- Frameless image-guided robotic radiosurgery is a safe and effective treatment for TN.
- Excellent pain control can be achieved with minimal major neurological complications.
- Repeat treatments offer pain relief but are associated with an increased risk of sensory side effects.
