The Key to a Successful PBC in Treatment of Trigeminal Neuralgia

As a minimally invasive treatment of trigeminal neuralgia, percutaneous balloon compression (PBC) has become increasingly popular worldwide. Because it is simple and straightforward, it does not need a complicated apparatus only a fluoroscope plus an operator's experience. Therefore, the surgical technique seems to be essential and worth further addressing. The paper stresses that the target of PBC should be the semilunar ganglion (the soma of neurons) rather than the rootlets (axons) because the latter is renewable. To obtain a sufficient pressure against the ganglion, Meckel's cave should be covered utterly by an inflating balloon, which fluoroscopically appears in a pear shape. To attain a proper balloon position, it is suggested to make a tunnel with a blunt stylet in a proper penetrative angle before inserting a soft catheter. Too large a pear is unnecessary, hence injecting should be stopped when growth becomes apparently slow. To avoid an unacceptable postoperative paresthesia, a prolonged compression is not encouraged.