Minimally Invasive Retrosigmoidal Parasterional Burr-Hole Approach: Technique and Neuropathic Pain Amelioration after Microvascular Decompression of the Trigeminal Nerve.

Autor:	Carrillo-Ruiz JD; Unit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, Mexico.; Coordination of Neuroscience, Faculty of Psychology, Mexico Anahuac University, Mexico City 52786, Mexico.; Research Direction, General Hospital of Mexico, Mexico City 06720, Mexico., Covaleda-Rodríguez JC; Unit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, Mexico.; Unit of Functional Neurosurgery and Stereotactic, Olaya Polyclinic Center, Bogota 111411, Colombia., Díaz-Martínez JA; Unit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, Mexico.; Department of Neurosurgery, Hospital Universitario 'Dr. José Eleuterio González', Monterrey 64460, Mexico., Vallejo-Estrella A; Unit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, Mexico., Navarro-Olvera JL; Unit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, Mexico., Velasco-Campos F; Unit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, Mexico., Armas-Salazar A; Unit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, Mexico.; Postgraduate Department, School of Higher Education in Medicine, National Polytechnic Institute, Mexico City 07360, Mexico., Cid-Rodríguez FX; Unit of Functional Neurosurgery, Stereotactic and Radiosurgery, General Hospital of Mexico, Mexico City 06720, Mexico.; Postgraduate Department, School of Higher Education in Medicine, National Polytechnic Institute, Mexico City 07360, Mexico.
Jazyk:	angličtina
Zdroj:	Biomedicines [Biomedicines] 2023 Oct 05; Vol. 11 (10). Date of Electronic Publication: 2023 Oct 05.
DOI:	10.3390/biomedicines11102707
Abstrakt:	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 ( p < 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 ( p < 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.
Databáze:	MEDLINE
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