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Updated: Aug 28, 2025
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Surgical and Clinical Outcomes of Microvascular Decompression: A Comparative Study between Young and Elderly Patients
Grazia Menna1, Alessandro Rapisarda2, Alessandro Izzo2
1Department of Neuroscience, Neurosurgery Section, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Abstract:
Microvascular decompression (MVD) is the only etiological technique for the treatment of trigeminal neuralgia (TN). Whilst there is a consensus MVD is likely effective regardless of age, the elderly population is thought to be more prone to have a higher rate of surgical complication, morbidity, and mortality. The main objective of our single-center, retrospective study was to analyze the surgical and clinical outcomes of MVD in TN elderly patients. From a surgical series of patients with TN who had undergone MVD from April 2018 to April 2022, 76 patients who matched the inclusion criteria were divided into two groups: twenty-five (32.9%) patients were older than 65 years and included in the elderly group, while the remaining fifty-one (61.1%) patients were below 65 years included in the non-elderly one. There were no differences between the groups in terms of acute pain relief (APR), Barrow Neurological Index (BNI) at follow-up, complications, and recurrence rate. In multivariate analysis (Cox proportional hazards regression analysis) the presence of an offending artery with nerve root distortion/indentation emerged as the only independent prognostic factor for pain-free survival (p = 0.0001). Our data endorse MVD as a safe and effective surgical procedure also for elderly patients with TN.
Insights
Microvascular decompression (MVD) is a safe and effective treatment for trigeminal neuralgia (TN) in elderly patients. This study found no significant differences in outcomes or complications compared to younger patients, supporting MVD for all age groups.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Microvascular decompression (MVD) is the primary etiological treatment for trigeminal neuralgia (TN).
- Concerns exist regarding increased surgical risks in elderly patients undergoing MVD for TN.
- This study evaluates MVD outcomes in elderly TN patients.
Purpose of the Study:
- To analyze the surgical and clinical outcomes of MVD in elderly patients with trigeminal neuralgia.
- To compare outcomes between elderly (≥65 years) and non-elderly (<65 years) TN patients undergoing MVD.
Main Methods:
- Retrospective single-center study of 76 TN patients who underwent MVD (April 2018 - April 2022).
- Patients were divided into elderly (n=25) and non-elderly (n=51) groups.
- Outcomes assessed included acute pain relief (APR), Barrow Neurological Index (BNI), complications, and recurrence. Multivariate analysis (Cox regression) was performed.
Main Results:
- No significant differences were observed between elderly and non-elderly groups in APR, BNI, complications, or recurrence rates.
- The presence of an offending artery causing nerve root distortion/indentation was the sole independent predictor of pain-free survival (p=0.0001).
Conclusions:
- Microvascular decompression is a safe and effective treatment for trigeminal neuralgia, even in elderly patients.
- Age is not a significant factor influencing MVD outcomes or complication rates in TN patients.
- Identifying an offending artery is crucial for predicting long-term pain relief in TN patients treated with MVD.
