Microvascular Decompression for Trigeminal Neuralgia: A Prospective, Multicenter Study

Area of Science:

• Neurosurgery
• Neurology
• Medical Research

Background:

• Microvascular decompression (MVD) is recognized as the most effective long-term treatment for trigeminal neuralgia (TGN).
• Existing evidence primarily comes from retrospective and single-center studies, lacking prospective, multicenter validation.

Purpose of the Study:

• To prospectively evaluate the short- and long-term outcomes of MVD in TGN patients.
• To assess complication rates associated with MVD at specialized Japanese institutions.

Main Methods:

• A prospective, multicenter study involving 166 TGN patients undergoing MVD between April 2012 and March 2015.
• Facial pain and complication data were collected at 7 days, 1 year, and 3 years postoperatively.
• Neuromonitoring was utilized in 84.3% of cases.

Main Results:

• Short-term complete pain relief was achieved in 78.9% of patients, with a 0% mortality rate and a 16.3% complication rate.
• Long-term follow-up (3 years) included 155 patients (93.4%), reporting 80.0% complete pain relief and a significantly reduced complication rate of 5.2%.
• The study included a substantial proportion of elderly patients (105 over 60 years).

Conclusions:

• MVD demonstrates high long-term efficacy and curative potential for TGN when performed by experienced neurosurgeons.
• Complications associated with MVD are generally uncommon and transient.
• MVD is confirmed as a safe and effective treatment option for TGN, including in the elderly population.