Minimally Invasive Retrosigmoidal Parasterional Burr-Hole Approach: Technique and Neuropathic Pain Amelioration after Microvascular Decompression of the Trigeminal Nerve
Background: Trigeminal neuralgia, a common condition in clinical practice, often occurs due to vascular compression caused by aberrant or ectopic arterial or venous vessels. Microvascular decompression through a minimally invasive retrosigmoidal approach has shown high rates of pain control, low com...
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MDPI AG
2023-10-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/10/2707 |
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| author | José Damián Carrillo-Ruiz Juan Camilo Covaleda-Rodríguez José Armando Díaz-Martínez Antonio Vallejo-Estrella José Luis Navarro-Olvera Francisco Velasco-Campos Armando Armas-Salazar Fátima Ximena Cid-Rodríguez |
| author_facet | José Damián Carrillo-Ruiz Juan Camilo Covaleda-Rodríguez José Armando Díaz-Martínez Antonio Vallejo-Estrella José Luis Navarro-Olvera Francisco Velasco-Campos Armando Armas-Salazar Fátima Ximena Cid-Rodríguez |
| author_sort | José Damián Carrillo-Ruiz |
| collection | DOAJ |
| description | Background: Trigeminal neuralgia, a common condition in clinical practice, often occurs due to vascular compression caused by aberrant or ectopic arterial or venous vessels. Microvascular decompression through a minimally invasive retrosigmoidal approach has shown high rates of pain control, low complication rates, and excellent therapeutic results. Objective: To describe the surgical technique and clinical outcomes in terms of pain relief after microvascular decompression of the trigeminal nerve through a minimally invasive retrosigmoidal parasterional burr-hole technique. Methods: A group of patients with trigeminal neuralgia refractory to medical management who underwent microvascular decompression were examined. The records of the patients were considered retrospectively (2016–2018), and the outcomes were considered based on the Visual Analogue Scale (VAS) and the Barrow Neurological Institute Pain Scale (BNIPS) added to a technical note of the surgical technique for a minimally invasive retrosigmoidal parasterional burr-hole. Results: Twenty-two patients were evaluated, and clinical assessment after surgical intervention showed a decrease in pain according to the VAS, resulting from an average preoperative state of 9.5 ± 0.37 to a postoperative condition of 1.32 ± 1.28, exhibiting statistically significant changes (<i>p</i> < 0.0001, d = 9.356). On the other hand, in relation to the BNIPS scale, a decrease from an average preoperative status of 4.55 ± 0.25 to a postoperative status at 12 months of 1.73 ± 0.54 was also demonstrated, showing significant changes (<i>p</i> < 0.0001, d = 3.960). Conclusion: Microvascular decompression of the trigeminal nerve through a minimally invasive retrosigmoidal parasterional burr-hole is feasible and can be a safe and effective technique for the management of pain. However, further research employing larger sample sizes and longer follow-up periods is necessary. |
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| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T21:25:30Z |
| publishDate | 2023-10-01 |
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| spelling | doaj.art-7431c341311b4375b6fe770860f01e852023-11-19T15:45:56ZengMDPI AGBiomedicines2227-90592023-10-011110270710.3390/biomedicines11102707Minimally Invasive Retrosigmoidal Parasterional Burr-Hole Approach: Technique and Neuropathic Pain Amelioration after Microvascular Decompression of the Trigeminal NerveJosé Damián Carrillo-Ruiz0Juan Camilo Covaleda-Rodríguez1José Armando Díaz-Martínez2Antonio Vallejo-Estrella3José Luis Navarro-Olvera4Francisco Velasco-Campos5Armando Armas-Salazar6Fátima Ximena Cid-Rodríguez7Unit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, MexicoUnit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, MexicoUnit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, MexicoUnit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, MexicoUnit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, MexicoUnit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, MexicoUnit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, MexicoUnit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, MexicoBackground: Trigeminal neuralgia, a common condition in clinical practice, often occurs due to vascular compression caused by aberrant or ectopic arterial or venous vessels. Microvascular decompression through a minimally invasive retrosigmoidal approach has shown high rates of pain control, low complication rates, and excellent therapeutic results. Objective: To describe the surgical technique and clinical outcomes in terms of pain relief after microvascular decompression of the trigeminal nerve through a minimally invasive retrosigmoidal parasterional burr-hole technique. Methods: A group of patients with trigeminal neuralgia refractory to medical management who underwent microvascular decompression were examined. The records of the patients were considered retrospectively (2016–2018), and the outcomes were considered based on the Visual Analogue Scale (VAS) and the Barrow Neurological Institute Pain Scale (BNIPS) added to a technical note of the surgical technique for a minimally invasive retrosigmoidal parasterional burr-hole. Results: Twenty-two patients were evaluated, and clinical assessment after surgical intervention showed a decrease in pain according to the VAS, resulting from an average preoperative state of 9.5 ± 0.37 to a postoperative condition of 1.32 ± 1.28, exhibiting statistically significant changes (<i>p</i> < 0.0001, d = 9.356). On the other hand, in relation to the BNIPS scale, a decrease from an average preoperative status of 4.55 ± 0.25 to a postoperative status at 12 months of 1.73 ± 0.54 was also demonstrated, showing significant changes (<i>p</i> < 0.0001, d = 3.960). Conclusion: Microvascular decompression of the trigeminal nerve through a minimally invasive retrosigmoidal parasterional burr-hole is feasible and can be a safe and effective technique for the management of pain. However, further research employing larger sample sizes and longer follow-up periods is necessary.https://www.mdpi.com/2227-9059/11/10/2707retrosigmoid approachparasterionalburr-holetrigeminal neuralgiasurgeryminimally invasive |
| spellingShingle | José Damián Carrillo-Ruiz Juan Camilo Covaleda-Rodríguez José Armando Díaz-Martínez Antonio Vallejo-Estrella José Luis Navarro-Olvera Francisco Velasco-Campos Armando Armas-Salazar Fátima Ximena Cid-Rodríguez Minimally Invasive Retrosigmoidal Parasterional Burr-Hole Approach: Technique and Neuropathic Pain Amelioration after Microvascular Decompression of the Trigeminal Nerve Biomedicines retrosigmoid approach parasterional burr-hole trigeminal neuralgia surgery minimally invasive |
| title | Minimally Invasive Retrosigmoidal Parasterional Burr-Hole Approach: Technique and Neuropathic Pain Amelioration after Microvascular Decompression of the Trigeminal Nerve |
| title_full | Minimally Invasive Retrosigmoidal Parasterional Burr-Hole Approach: Technique and Neuropathic Pain Amelioration after Microvascular Decompression of the Trigeminal Nerve |
| title_fullStr | Minimally Invasive Retrosigmoidal Parasterional Burr-Hole Approach: Technique and Neuropathic Pain Amelioration after Microvascular Decompression of the Trigeminal Nerve |
| title_full_unstemmed | Minimally Invasive Retrosigmoidal Parasterional Burr-Hole Approach: Technique and Neuropathic Pain Amelioration after Microvascular Decompression of the Trigeminal Nerve |
| title_short | Minimally Invasive Retrosigmoidal Parasterional Burr-Hole Approach: Technique and Neuropathic Pain Amelioration after Microvascular Decompression of the Trigeminal Nerve |
| title_sort | minimally invasive retrosigmoidal parasterional burr hole approach technique and neuropathic pain amelioration after microvascular decompression of the trigeminal nerve |
| topic | retrosigmoid approach parasterional burr-hole trigeminal neuralgia surgery minimally invasive |
| url | https://www.mdpi.com/2227-9059/11/10/2707 |
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