Efficacy analysis of microvascular decompression and percutaneous balloon compression for trigeminal neuralgia secondary to vertebrobasilar dolichoectasia: a retrospective cohort study

作者：Ziwei Gao, Renfu Liu, Peng Lin, Xiangtao Zhang, Yawen Xu, Yuanxiang Lin, Pei‐Sen Yao · 发表于：Acta Neurochirurgica · 年份：2025 · DOI：10.1007/s00701-025-06651-z · 被引用次数：4 · 研究领域：Trigeminal Neuralgia and Treatments、Intracranial Aneurysms: Treatment and Complications、Facial Rejuvenation and Surgery Techniques

BACKGROUND: Trigeminal neuralgia secondary to vertebrobasilar dolichoectasia (VBD-TN) poses a significant challenge in the surgical management of trigeminal neuralgia. This study aimed to evaluate and compare the therapeutic efficacy of microvascular decompression (MVD) and percutaneous balloon compression (PBC) in patients with VBD-TN. METHODS: We conducted a retrospective cohort analysis of consecutive VBD-TN patients treated at a tertiary hospital in China between September 2013 and August 2022. Participants were stratified by the intervention (MVD vs PBC), with systematic evaluation of postoperative pain control efficacy and complication rates. RESULTS: This study enrolled 107 patients with VBD-TN, with a mean age of 64.8 ± 10.0 years and a mean follow-up duration of 3.9 ± 1.9 years. The cohort comprised 64 patients undergoing MVD and 43 receiving PBC. Both groups achieved excellent initial pain control (The Barrow Neurological Institute scoring system (BNI) pain score I or II). The recurrence (BNI Ⅲ, Ⅳ, Ⅴ) rates were 12.5% (8/64) in the MVD group versus 20.9% (9/43) in the PBC group (p = 0.242) at the last follow-up, showing no statistically significant difference. Early postoperative assessment revealed significantly higher incidences of trigeminal dysfunction including facial numbness, dry eye symptoms, and masticatory muscle weakness in the PBC group compared to the MVD group (p < 0.05 for all). Conversely, the MVD group demonstrated more diverse complications, with c...