Robot-assisted percutaneous balloon compression for trigeminal neuralgia- preliminary experiences

Area of Science:

• Neurosurgery
• Medical Robotics
• Pain Management

Background:

• Trigeminal neuralgia (TN) is a chronic pain condition affecting the trigeminal nerve.
• Percutaneous balloon compression (PBC) is an established treatment for TN.
• Robot-assisted surgery offers potential for enhanced precision and safety in neurosurgical procedures.

Purpose of the Study:

• To evaluate the feasibility and preliminary outcomes of robot-assisted percutaneous balloon compression (PBC) for treating trigeminal neuralgia (TN).
• To introduce a novel fixing plug and trajectory planning for robot-assisted PBC.
• To assess the efficacy and safety of this technique in managing TN pain.

Main Methods:

• Nine patients with TN underwent robot-assisted PBC between June and September 2022.
• A custom fixing plug was employed for robot-assisted PBC.
• Three-dimensional structured light registration guided the puncture trajectory through the foramen ovale.
• Pain and numbness were assessed using the Numerical Rating Scale (NRS) and Barrow Neurological Institute (BNI) scores.

Main Results:

• Robot-assisted PBC was successfully performed in all nine patients, with a mean registration error of 0.68 mm.
• All punctures of the foramen ovale were completed in a single attempt.
• Post-procedure, all patients experienced significant pain relief, with some reporting transient facial numbness and masseter weakness that resolved over time.

Conclusions:

• Robot-assisted PBC, guided by 3D structured light registration, is a viable and effective treatment option for trigeminal neuralgia.
• The defined puncture trajectory through the foramen ovale proved safe and effective.
• This technique holds promise for improving outcomes in TN management.