Introduction: A retrospective review of patients with trigeminal neuralgia, treated with 3 modalities: Radiofrequency (RF), neurovascular decompression (MVD), and radiosurgery (RS).
Methods: Retrospective review of 143 patients treated with RF, MVD, or RS for control of trigeminal neuralgia.
Results: Thirty patients were treated with RF. Seventeen (57%) required a second procedure. Of the RF patients who did not need a second procedure, all have had excellent short term relief. Nine of the remaining 13 patients (69%) have suffered from facial numbess related to the procedure, and a quarter (4/13 or 31%) are still on medication. Total Hospital fees for the RF were (mean+/- SD) $4000+/- 600.
Of the 42 treated with MVD, 6 pts have required a second procedure (14%). Over 90% of the rest (33/36 or 92%) are pain free. Six of the reamaining patients (17%) have facial numbness, and only 22% are on medication. Total hospital fees for MVD were $48100 +/- 5500.
Of the 71 treated with SRS, 11 (15%) have recurred necessitating a second procedure. Of the remaining 60 patients, 52(87%) are pain free, 11 (18%) have facial numbness, and 28 (47%) are still on medication. Total hospital fees for the SRS were $39200 +/- 5600.
Conclusions: Of the 3 types of remedies, RF though the most economical, produces only short term relief with over half of the patients ultimately requiring a second procedure. Though SRS is associated with excellent pain relief, over one third are still on medication. MVD is the best choice of treatment in patients without a risk factor, and is least likely to require a subsequent procedure
Patient Care: Patients will make an informed choice regarding treatment options and awareness regarding cost effectiveness
Learning Objectives: The intent is to compare results in terms of the need for one or more secondary procedures, pain relief, associated numbness, continued medication, and cost.