Factors associated with outcomes following microvascular decompression for the treatment of primary trigeminal neuralgia in adults: a systematic review and meta-analysis.
Pablo Gomes-da Silva de RosenzweigSantiago Pastrana-BrandesSalomon Merikansky-GersonLuis Octavio Victoria-GarciaMagdalena Sophia Curtius-CarusoJosé Damián Carrillo-RuizPublished in: Journal of dental anesthesia and pain medicine (2024)
This study aimed to evaluate pain assessment strategies and factors associated with outcomes after microvascular decompression for the treatment of primary trigeminal neuralgia in adults. We conducted a systematic review and meta-analysis of English, Spanish, and French literature. We searched three databases, PubMed, Ovid, and EBSCO, from 2010 to 2022 and selected studies including patients with primary trigeminal neuralgia, clear pain assessment, and pain outcomes. Population means and standard deviations were calculated. Studies that included factors associated with postoperative outcomes were included in the meta-analysis. A total of 995 studies involving 5673 patients with primary trigeminal neuralgia following microvascular decompression were included. Patients with arteries compressing the trigeminal nerve demonstrated optimal outcomes following microvascular decompression (odds ratio [OR]= 0.39; 95% confidence interval [CI] = 0.19-0.80; X 2 = 46.31; Dof = 15; I 2 = 68%; P = < 0.0001). Conversely, when comparing arterial vs venous compression of the trigeminal nerve (OR = 2.72; 95% CI = 1.16-6.38; X 2 = 23.23; Dof = 10; I 2 = 57%; P = 0.01), venous compression demonstrated poor outcomes after microvascular decompression. Additionally, when comparing single-vessel vs multiple-vessel compression (OR = 2.72; 95% CI = 1.18-6.25; X 2 = 21.17; Dof = 9; I 2 = 57%; P = 0.01), patients demonstrated unfavorable outcomes after microvascular decompression. This systematic review and meta-analysis evaluated factors associated with outcomes following microvascular decompression (MVD) for primary trigeminal neuralgia (PTN). Although MVD is an optimal treatment strategy for PTN, a gap exists in interpreting the results when considering the lack of evidence for most pain assessment strategies.
Keyphrases
- neuropathic pain
- minimally invasive
- chronic pain
- systematic review
- spinal cord
- spinal cord injury
- pain management
- case control
- randomized controlled trial
- end stage renal disease
- metabolic syndrome
- newly diagnosed
- peritoneal dialysis
- ejection fraction
- adipose tissue
- type diabetes
- insulin resistance
- deep learning
- patient reported outcomes
- artificial intelligence
- big data
- smoking cessation