Older Patients Have Better Pain Outcomes Following Microvascular Decompression for Trigeminal Neuralgia

Sarah K. Bick, David Huie, Gabriel Sneh, Emad N. Eskandar

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND: Trigeminal neuralgia (TN) increases in prevalence with age. Although microvascular decompression (MVD) is the most effective long-term operative treatment for TN, its use in older patient populations has been debated due to its invasive nature. Recent studies have demonstrated safety of MVD in older patients; however, efficacy data are more limited. OBJECTIVE: To determine the relationship between age and pain outcomes following MVD for TN. METHODS: Subjects underwent MVD for TN at our institution between 1/1/2004 and 12/31/2013, had typical TN, and demonstrated neurovascular compression on preoperative imaging. We performed a retrospective case series study by reviewing the electronic medical records and performing phone interviews to determine long-term outcomes. We divided patients into 2 groups for analysis, under 60 and 60 yr of age and older. RESULTS: One hundred twenty-four subjects were included in the study, 82 under 60, and 42 60 yr of age and older. The average length of follow-up was 42.4 mo. Patients in the older age group had average pain score of 1.57 at most recent follow-up, while for the younger age group it was 2.18 (P = .0084). Multiple regression analysis found that older age, male gender, and preoperative medication responsiveness were significantly correlated with lower long-term pain scores, while V2 dermatome involvement was correlated with higher long-term pain scores. CONCLUSION: Patients 60 yr of age and older have significantly better long-term pain outcomes following MVD than younger patients.

Original languageEnglish (US)
Pages (from-to)116-122
Number of pages7
JournalNeurosurgery
Volume84
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Microvascular Decompression Surgery
Trigeminal Neuralgia
Pain
Age Groups
Electronic Health Records
Regression Analysis
Interviews
Safety
Population

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Older Patients Have Better Pain Outcomes Following Microvascular Decompression for Trigeminal Neuralgia. / Bick, Sarah K.; Huie, David; Sneh, Gabriel; Eskandar, Emad N.

In: Neurosurgery, Vol. 84, No. 1, 01.01.2019, p. 116-122.

Research output: Contribution to journalArticle

Bick, Sarah K. ; Huie, David ; Sneh, Gabriel ; Eskandar, Emad N. / Older Patients Have Better Pain Outcomes Following Microvascular Decompression for Trigeminal Neuralgia. In: Neurosurgery. 2019 ; Vol. 84, No. 1. pp. 116-122.
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