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Updated: Jul 3, 2026
Microvascular Decompression: Salient Surgical Principles and Technical Nuances
Published on: July 5, 2011
Long-Term Outcomes of Microvascular Decompression for Trigeminal Neuralgia: The Prognostic Role of Age and
Junjie Yang1, Minhao Huang1, Chengkai Yang1
1Department of Neurosurgery, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Objective:
To evaluate long-term pain outcomes and safety after microvascular decompression (MVD) for primary trigeminal neuralgia (TN) in a single-center cohort and to explore whether age and intraoperative neurovascular compression severity were associated with favorable long-term pain relief.
Methods:
We retrospectively reviewed 134 consecutive patients with primary TN who underwent first-time MVD between January 2016 and December 2018 at a single institution, with at least 36 months of follow-up. Pain outcomes were assessed using the Barrow Neurological Institute (BNI) pain intensity scale. Postoperative complications, medication use, Kaplan-Meier analysis, and uni- and multivariable logistic regression were used to evaluate outcomes and associated factors.
Results:
At 1 month after surgery, 95% of patients achieved favorable pain relief (BNI grades I-III). At the final follow-up, 77% maintained favorable pain relief, and 69 patients achieved complete pain relief (BNI grade I). Ninety-four patients reduced antiepileptic medication use by at least 50%, and 69 discontinued medication completely. The most common complications were dizziness (4.4%), facial numbness (2.9%), and hearing impairment (2.9%). Age ≥70 years and significant intraoperative neurovascular compression were independently associated with favorable long-term pain relief.
Conclusions:
In this retrospective single-center series, MVD was associated with durable pain relief, substantial medication reduction, and an acceptable complication profile. Age ≥70 years and significant intraoperative neurovascular compression were associated with favorable long-term pain relief in our cohort. These findings reflect institutional experience and may assist patient selection and counseling.
