Turkish Neurosurgery 2011 , Vol 21 , Num 1
Long-Term Outcomes of Percutaneous Retrogasserian Glycerol Rhizotomy in 3370 Patients with Trigeminal Neuralgia
Wang XU-HUI, Zhou CHUN, Shen GUANG-JIAN, Xu MIN-HUI, Chen GUANG-XIN, Zou YONG-WEN, Xu LUN-SHAN
Research Institute of Surgery & Daping Hospital, Third Military Medical University, Department of Neurosurgery, Chongqing, China DOI : 10.5137/1019-5149.JTN.3550-10.1 AIM: To assess the long-term outcomes of percutaneous retrogasserian glycerol rhizotomy (PRGR) in patients with medically unresponsive idiopathic trigeminal neuralgia.

MATERIAL and METHODS: A total of 3370 patients undergoing PRGR between 1983 and 2003 in our hospital were followed up for 13.1 years (range 3-23 years), and the outcomes were investigated.

RESULTS: Of the 3370 patients, 99.58% had complete initial pain relief. A total of 2750 patients were followed up when 112 died of unrelated causes and 508 were lost to follow up. Of the 2750 patients, 962 (35%) had pain recurrence at various intervals: 0.3% in 1 year; 21% in 1 to 5 years; 7% in 5 to 10 years; 4% in 10 to 15 years and 3% in 15 to 23 years. The major complication was facial numbness, among which hypesthesia outweighed hypalgesia. Most patients recovered within half a year, although 109 patients (3.96%) developed permanent mild hypesthesia. There was no anesthesia dolorosa or surgery related mortality in this series.

CONCLUSION: PRGR is a minimally invasive and simple procedure yielding a favorable outcome for trigeminal neuralgia. The major complications of this procedure are reversible within various time intervals. It may serve as a first-line surgical modality for patients unresponsive to pharmacotherapy. Keywords : Trigeminal neuralgia, Percutaneous retrogasserian glycerol rhizotomy, Hypesthesia, Recurrence

Corresponding author : Xu Lun-shan, kevin6811@yeah.net