Journal of Shandong University (Health Sciences) ›› 2021, Vol. 59 ›› Issue (1): 28-33.doi: 10.6040/j.issn.1671-7554.0.2020.0686

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Comparison of efficacy of gamma knife radiosurgery and microvascular decompression in the treatment of primary trigeminal neuralgia

WANG Liangliang1, ZHANG Ming1, SUN Zhenwei1, DING Shouluan2, FAN Yuefei1, WANG Chengwei1   

  1. 1. Department of Neurosurgery;
    2. Center of Evidence-Based Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China
  • Published:2021-01-09

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Abstract: Objective To compare the efficacy and safety of gamma knife surgery(GKS)and microvascular decompression(MVD)for primary trigeminal neuralgia(PTN). Methods A total of 76 patients with PTN were included in this study since 2016(GKS: 40 cases, MVD: 36 cases). The maximum follow-up lasted for 40 months. The efficacy and complication rate of the two treatment methods were evaluated with t-test and Wilcoxon signed rank sum test. Results The difference between preoperative and postoperative BNI was statistically significant(GKS: Z=-5.069, P<0.001; MVD: Z=-5.292, P<0.001). The pain relief effect time after GKS was significantly longer than that after MVD ［GKS:(75.00±115.50)days; MVD:(2.0±0.00)days］, and the difference was statistically significant(U=248.5, P<0.001). There was significant difference in the degree of pain relief between the MVD group and GKS group(U=500, P=0.013). The complication rate of MVD(38.9%)was higher than that of GKS(20.0%), but the difference was not statistically significant(χ2=3.287, P=0.070). There was statistically significant difference in the costs ［GKS:(12 236±1 831)yuan, MVD:(37 671±5 221)yuan, U=2.0, P<0.001］. Conclusion Both GKS and MVD are effective measures in the treatment of PTN. MVD can obtain immediate pain relief but it has higher surgical risks and costs than GKS. As a safe and minimally invasive treatment, GKS takes a long time for pain relief. Individualized, comprehensive treatment plans should be developed according to the specific conditions of patients.

Key words: Gamma knife, Microvascular decompression, Trigeminal neuralgia, Radiosurgery

CLC Number: 

  • R651.1+9
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