The Effectiveness And Safety Of Neurosurgical Treatment Via Retrosigmoid Approach In Elderly Patients With Trigeminal Neuralgia

Objective The purpose of this study was to evaluate the effectiveness and safety of retrosigmoid approach in treating older patients with trigeminal neuralgia(TN)and to explore predictors of long-term outcomes.Methods In this retrospective study,32 patients(70 and over,elderly group)and 102 patients(under 70,young group)underwent Microvascular decompression(MVD),MVD+partial sensory rhizotomy(PSR)and PSR for idiopathic TN from July 2009 to December 2018.The two groups were compared for immediate,long-term pain outcome and postoperative complications.All perioperative data were collected from medical records and telephone interviews.The pain outcomes were assessed with the Barrow Neurological Institute(BNI)pain score.Multiple analysis was used to determine the predictors of long-term outcomes.Results All patients were followed up for an average of 62.4 months(13.2-124.8 months).93.8%of the elderly patients and 89.2%of the young patients achieve "Good" immediate pain outcome(BNI Ⅰ-Ⅱ),the proportion were 75.0%and 59.8%,respectively,in long-term pain outcome.No statistically significant differences existed in the immediate and long-term pain outcome between the elderly and young patients(P=0.121 and P=0.119,respectively).There was no significant difference in the incidence of neurological and non-neurological complications between two groups.Multiple analysis found that pure arterial compressing and shorter disease duration are predictors of favorable long-time outcome.Conclusions Compared with young patients,the treatment for TN in elderly patients via retrosigmoid approach has the same favorable pain outcome.The safety of this procedure for elderly TN patients is similar to that in young patients.