Study On Factors Related To Operative Effect Of Multimodal Assisted Percutaneous Balloon Puncture For Primary Trigeminal Neuralgia

Objective To explore the surgical effect in the treatment of primary trigeminal neuralgia(PTN)between the percutaneous balloon compression(PBC)assisted by multimode and conventional PBC,the study was conducted to provide the related date support for the application value of multimodal assistive technology in minimally invasive treatment of PTN.Methods Clinical data of 68 patients diagnosed with PTN and treated with PBC in XXX Hospital from June 2021 to June 2022 were retrospectively analyzed.Patients in the department of pain receiving the treatment of conventional PBC(empirical puncture based on anatomy)were classified as the conventional control group(a total of 30 cases).Patients in the department of neurosurgery receiving the treatment of PBC based on the assistance of multi-modal(including 3D Slicer planning of surgical puncture path,3D printing of facial puncture guide assisted positioning and conical beam computed tomography to verify balloon morphology)were classified as the image fusion group(a total of 38 cases).The basic clinical data,balloon shape,postoperative pain relief,surgical clinical efficacy,postoperative complications,trigeminal cardiac reflex and surgical duration of the two groups were analyzed and compared,and the differences in clinical efficacy of the two treatments were discussed.Statistical analysis of multi-modal assisted PBC puncture data was conducted to provide the related date support for the application value of multimodal assistive technology in minimally invasive treatment of PTN.Results1.There was no significant difference in basic clinical data(including gender,age,pain side,course of disease,pain site,past medical history,and previous PTN surgical treatment)between conventional control group and image fusion group(P>0.05).2.In the conventional control group,the shaped of balloon was pear about 22 cases and the shaped of balloon was not pear about 8 cases.In the image fusion group,the shaped of balloon was pear about 35 cases and the shaped of balloon was not pear about 3 cases.The difference of balloon shape between the conventional control group and the image fusion group was statistically significant(P<0.05).3.VAS scores between the conventional control group and the image fusion group were used to evaluate the relief of surgical pain.There was significant difference between the two groups in VAS scores before and after surgery(P < 0.001).The BNI-P score between the conventional control group and the image fusion group showed no significant difference in the clinical efficacy at 3 hours after surgery and 3 months after surgery(P>0.05),while the difference was statistically significant at 6 months after surgery(P<0.05).4.There was no significant difference in postoperative complications(including facial numbness,masticatory muscle weakness,oral herpes and diplopia)between the conventional control group and the image fusion group(P>0.05).No intracranial infection occurred about the two groups after surgery.There was no significant difference about the intraoperative trigeminal cardiac reflex in the two groups(P > 0.05).There was statistically significant difference in operation duration about the two groups(P<0.001).Conclusion The surgery of PBC assisted by multi-modal fusion can achieve accurate positioning and simulate the surgical approach before operative.During the operation,the established puncture path was performed thought the surgical approach by simulating.The PBC surgery assisted by multimodal fusion effectively avoided the vascular passage on the surgical path,shortened the operation time of PBC,improved the pear-like shaped balloon forming rate of PBC and improved the clinical efficacy of PBC in the treatment of PTN.And PBC is expected to be the preferred surgical method for the surgical treatment of PTN.