Analysis Of Key Factors In Short-term Efficacy And Recurrence Of Percutaneous Balloon Compression

Purpose:To determine the key factors affecting the prognosis of patients with percutaneous balloon compression of trigeminal neuralgia and provide more accurate surgical methods for patients.Method:We retrospectively analyzed 116 patients with primary trigeminal neuralgia who underwent percutaneous balloon compression under anatomical localization and O-arm guidance from May 2017 to February 2018.All patients were followed up for 1 year after operation,and the medical and surgical records of the patients were retrospectively analyzed to determine the key factors between the following parameters and short-term and long-term outcomes:gender,age,pain branch,hypertension grade,body mass index,position relationship between Mark at the end of the balloon and lateral ramp line,balloon morphology,balloon filling volume,and compression time.Univariate,multivariate analysis,and multivariate backwards logistic regression analysis were used to test statistical significance.Results:1.Univariate logistic regression analysis showed that hypertension,compression time,and compression location were not significantly associated with short-term outcomes.Hypertension was significantly associated with recurrence(P< 0.05).2.Multivariate logistic retrospective analysis showed that the pain branch was significantly associated with short-term outcomes(P =0.006),and balloon volume(< 1.5x V.S.≥ 1.5x)was significantly associated with short-term outcomes(P <0.039).Blast shape(pear-shaped v.S.non-pear-shaped)was significantly associated with recurrence(P < 0.001)and hypertension was significantly associated with recurrence(P=0.039).3.Other factors,including gender,age,body mass index,the relationship between Mark at the end of the balloon and the position of the slope line,were not significantly associated with short-term efficacy and recurrence.Conclusion:1.The shape during balloon inflation is a parameter that has a great impact on the results,and the pear row is significantly different from the non-pear row.2.The foramen ovale was first punctured and a Mark was successfully placed,followed by 3D scanning through the O-arm,and neuronavigation fused the preoperative 3.0TMRA with 3D scanning to ensure that the balloon catheter was located in the Meckel’s cavity and entered the posterior fossa through the trigeminal impression.At this time,when the volume of the balloon is more than1.5 times,the probability of pear formation in which the balloon tip protrudes into the trigeminal impression is formed.3.Discontinuation of surgery should be considered for long-lasting oval balloon shapes.4.There is no difference in results between 90 seconds and longer compression time.5.Previous hypertension was not associated with short-term efficacy,but was closely related to recurrence,and pain in the second branch of the trigeminal nerve was more effective than other branches.