How Does Changing the Time to Surgery Affect the Recurrence of Post-Traumatic Trigeminal Neuropathic Pain

Area of Science:

• Neurosurgery
• Pain Medicine
• Neurology

Background:

• Post-traumatic trigeminal neuropathic pain (PTTNp) recurrence after microneurosurgery remains poorly understood.
• Identifying factors influencing PTTNp recurrence is crucial for patient management.

Purpose of the Study:

• To investigate the impact of the time interval between trigeminal nerve injury and surgical repair on PTTNp recurrence.
• To determine if earlier surgical intervention correlates with better outcomes.

Main Methods:

• Retrospective cohort study of 60 patients with PTTNp undergoing trigeminal nerve surgery.
• Patients were stratified into four groups based on time from injury to surgery (0-100, 101-200, 201-300, >300 days).
• Primary outcome assessed was PTTNp presence/absence at 6 months post-surgery using neurosensory testing; statistical analysis included ANOVA and Tukey-Kramer tests.

Main Results:

• A statistically significant difference in PTTNp recurrence was observed among the groups (P = .0002).
• Surgical intervention within 200 days of injury resulted in significantly lower PTTNp recurrence rates.
• Over 60% of patients treated within 200 days experienced no neuropathic pain at 6 months, compared to 41.6% across all groups.

Conclusions:

• The timing of surgical intervention for PTTNp significantly influences pain recurrence.
• Optimal outcomes for PTTNp are achieved with operative treatment initiated within 200 days of the initial injury.