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Description of associated morbidity and complication avoidance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>One hundred sixty-five patients with TGN underwent 171 MVD surgeries at the authors\u2019 institution. Patient characteristics and magnetic resonance imaging (MRI) datasets were obtained through the hospital\u2019s archiving system. Patients provided information about pre- and post-operative pain characteristics and neurologic outcome. Favorable outcome was defined as a Barrow Neurological Institute (BNI) pain intensity score of I to III with post-operative improvement of I grade.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Type of TGN pain with purely paroxysmal pain (<jats:italic>p<\/jats:italic>\u2009=\u20090.0202*) and TGN classification with classical TGN (<jats:italic>p<\/jats:italic>\u2009=\u20090.0372*) were the only significant predictors for long-term pain relief. Immediate pain relief occurred in 90.6% of patients with a recurrence rate of 39.4% after 3.5\u2009\u00b1\u20094.6\u00a0years. MRI reporting of a neurovascular conflict had a low negative predictive value of 39.6%. Mortality was 0% with major complications observed in 8.2% of patients. Older age was associated with lower complication rates (<jats:italic>p<\/jats:italic>\u2009=\u20090.0009***). Re-MVD surgeries showed improved long-term pain relief in four out of five cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>MVD is a safe and effective procedure even in the elderly. It has the unique potential to cure TGN if performed on a regular basis, and if\u00a0key surgical steps are respected. Early MVD should be offered in case of medical treatment failure and paroxysmal pain symptoms. The presence of a neurovascular conflict on MRI is not mandatory. In case of recurrence, re-MVD is a good treatment option that should be discussed with patients.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Highlights<\/jats:title>\n                <jats:p>\u2022 Long-term analysis of pain relief after MVD.<\/jats:p>\n                <jats:p>\u2022 Positive predictors for outcome: classical TGN and purely paroxysmal pain.<\/jats:p>\n                <jats:p>\u2022 Presence of neurovascular conflict in MRI is not mandatory for MVD surgery.<\/jats:p>\n                <jats:p>\u2022 Analysis of complications and surgical nuances for avoidance.<\/jats:p>\n                <jats:p>\u2022 MVD is a safe procedure also in the elderly.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00701-021-05028-2","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T09:02:41Z","timestamp":1634806961000},"page":"3321-3336","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Microvascular decompression in trigeminal neuralgia: predictors of pain relief, complication avoidance, and lessons learned"],"prefix":"10.1007","volume":"163","author":[{"given":"Johannes","family":"Herta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Schmied","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa Bettina","family":"Loidl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-te","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Marik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Winter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Tomschik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heber","family":"Ferraz-Leite","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"R\u00f6ssler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Dorfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,21]]},"reference":[{"key":"5028_CR1","doi-asserted-by":"publisher","first-page":"1093","DOI":"10.1007\/s10143-020-01296-1","volume":"44","author":"EN Alford","year":"2021","unstructured":"Alford EN, Chagoya G, Elsayed GA, Bernstock JD, Bentley JN, Romeo A, Guthrie B (2021) Risk factors for wound-related complications after microvascular decompression. 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