Publication year: 2012
Source: World Neurosurgery, Available online 26 January 2012
Heng Zhang, Ding Lei, Chao You, Bo-Yong Mao, Bo Wu, ...
ObjectiveThe aim of this study is to provide credible and comparable evidence on the efficacy and safety of pure MVD for primary TN, and also to find out the possible prognostic factors of excellent long-term outcome after the surgery.MethodA prospective cohort study was conducted, involving the patients who met the diagnostic criteria of primary TN (both typical and atypical). The cohort patients underwent pure MVD, and then were followed up by independent neurologists. The possible prognostic factors were analyzed via Logistic method.ResultAll 154 consecutive primary TN patients (98 typical cases, 56 atypical cases) underwent pure MVD from January 2001 to November 2005. The patients were followed up for median 5.6 years (10 lost in 5 years). Respective initial and 5-year's complete pain-free without medication (BNI pain scored I) rates were 84% and 72% for total primary TN, 87% and 80% for typical TN, while 79% and 54% for atypical TN. The Kaplan-Meier survival curves of 5 years demonstrated different long-term outcomes in different groups (typical TN vs. atypical TN). The typical symptoms (OR 2.776), preoperative MR indicating vessel compression (OR 2.950), and obvious vessel compression found during operation (OR 3.219) were proved having positive effect on long-term pain relief without medication.ConclusionThis is a perspective cohort study of pure MVD, which confirms the long-term effectiveness and safety of the surgery for primary TN. Patients with typical symptoms, positive MR findings, or obvious vessel compressions might have better long-term prognosis.
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