{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:57:39Z","timestamp":1792213059953,"version":"4.4.0"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,1]]},"abstract":"\n Object<\/jats:title>\n Because the incidence of trigeminal neuralgia (TN) increases with age, neurosurgeons frequently encounter elderly patients with this disorder. Although microvascular decompression (MVD) is the only etiological therapy for TN with the highest initial efficacy and durability of all treatments, it is nonetheless associated with special risks (cerebellar hematoma, cranial nerve injury, stroke, and death) not seen with the commonly performed ablative procedures. Thus, the safety of MVD in the elderly remains a concern. This prospective study and systematic review with meta-analysis was conducted to determine whether MVD is a safe and effective treatment in elderly patients with TN.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this prospectively conducted analysis, 36 elderly patients (mean age 73.0 \u00b1 5.9 years) and 53 nonelderly patients (mean age 52.9 \u00b1 8.8 years) underwent MVD over the study period. Outcome and complication data were recorded.<\/jats:p>\n The authors also conducted a systematic review of the English literature published before December 2009 and providing outcomes and complications of MVD in patients with TN above the age of 60 years. Pooled complication rates of stroke, death, cerebellar hematoma, and permanent cranial nerve deficits were analyzed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Thirty-one elderly patients (86.1%) reported an excellent outcome after MVD (mean follow-up 20.0 \u00b1 7.0 months). Twenty-five elderly patients with Type 1 TN were compared with 26 nonelderly patients with Type 1 TN, and no significant difference in outcomes was found (p = 0.046). Three elderly patients with Type 2a TN were compared with 12 nonelderly patients with Type 2a TN, and no significant difference in outcomes was noted (p = 1.0). Eight elderly patients with Type 2b TN were compared with 15 nonelderly patients with Type 2b TN, and no significant difference in outcomes was noted (p = 0.086). The median length of stay between cohorts was compared, and no significant difference was noted (2 days for each cohort, p = 0.33). There were no CSF leaks, no cerebellar hematomas, no strokes, and no deaths.<\/jats:p>\n Eight studies (1334 patients) met the inclusion criteria for the meta-analysis. For none of the complications was the incidence significantly more frequent in elderly patients than in the nonelderly.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Although patient selection remains important, the authors' experience and the results of this systematic review with meta-analysis suggest that the majority of elderly patients with TN can safely undergo MVD.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2010.6.jns10142","type":"journal-article","created":{"date-parts":[[2010,7,23]],"date-time":"2010-07-23T10:08:17Z","timestamp":1279879697000},"page":"172-179","source":"Crossref","is-referenced-by-count":117,"title":["Microvascular decompression for elderly patients with trigeminal neuralgia: a prospective study and systematic review with meta-analysis"],"prefix":"10.3171","volume":"114","author":[{"given":"Raymond F.","family":"Sekula","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Frederickson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Jannetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew R.","family":"Quigley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled M.","family":"Aziz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory D.","family":"Arnone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns10142","series-title":"Healthcare Cost and Utilization Project (HCUP): HCUP Quality Control Procedures","author":"Agency for Healthcare Research and Quality","year":"2008"},{"key":"b2-jns10142","series-title":"J Neurosurg","first-page":"916","article-title":"Repeat posterior fossa exploration for patients with persistent or recurrent idiopathic trigeminal neuralgia","volume":"108","author":"Amador","year":"2008"},{"key":"b3-jns10142","series-title":"Neurosurgery","first-page":"840","article-title":"Microvascular decompression for trigeminal neuralgia in the elderly: a review of the safety and efficacy","volume":"55","author":"Ashkan","year":"2004"},{"key":"b4-jns10142","series-title":"N Engl J Med","first-page":"1077","article-title":"The long-term outcome of microvascular decompression for trigeminal neuralgia","volume":"334","author":"Barker","year":"1996"},{"key":"b5-jns10142","series-title":"Br J Neurosurg","first-page":"76","article-title":"Microvascular decompression for trigeminal neuralgia in patients over 65 years of age","volume":"15","author":"Berk","year":"2001"},{"key":"b6-jns10142","series-title":"Neurosurgery","first-page":"E799","article-title":"Microvascular decompression for trigeminal neuralgia in the elderly: a review of the safety and efficacy","author":"Broggi","year":"58"},{"key":"b7-jns10142","series-title":"Neurosurgery","first-page":"783","article-title":"Longterm results of percutaneous retrogasserian thermorhizotomy for \u201cessential\u201d trigeminal neuralgia: considerations in 1000 consecutive patients","volume":"26","author":"Broggi","year":"1990"},{"key":"b8-jns10142","series-title":"J Neurosurg","first-page":"687","article-title":"Editorial. Microvascular decompression for trigeminal neuralgia","volume":"108","author":"Burchiel","year":"2008"},{"key":"b9-jns10142","series-title":"Neurosurgery","first-page":"1164","article-title":"A new classification for facial pain","volume":"53","author":"Burchiel","year":"2003"},{"key":"b10-jns10142","series-title":"JAMA","first-page":"1385","article-title":"The existence of publication bias and risk factors for its occurrence","volume":"263","author":"Dickersin","year":"1990"},{"key":"b11-jns10142","series-title":"Anesthesiology","first-page":"111","article-title":"New classification of physical status","volume":"24","author":"Dripps","year":"1963"},{"key":"b12-jns10142","series-title":"J Neurosurg","first-page":"359","article-title":"Retreatment of trigeminal neuralgia with Gamma Knife radiosurgery: is there an appropriate cumulative dose? Clinical article","volume":"111","author":"Dvorak","year":"2009"},{"issue":"5","key":"b13-jns10142","series-title":"Neurosurg Focus","first-page":"E3","article-title":"Trigeminal neuralgia: definition and classification","volume":"18","author":"Eller","year":"2005"},{"key":"b14-jns10142","series-title":"Neurol Sci","first-page":"23","article-title":"Advanced age as a contraindication to microvascular decompression for drug-resistant trigeminal neuralgia: evidence of prejudice?","volume":"31","author":"Ferroli","year":"2010"},{"key":"b15-jns10142","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1405","article-title":"Recurrent trigeminal neuralgia: long term outcome of repeat gamma knife radiosurgery","volume":"79","author":"Gellner","year":"2008"},{"key":"b16-jns10142","series-title":"Neurology","first-page":"1183","article-title":"Practice parameter: the diagnostic evaluation and treatment of trigeminal neuralgia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the European Federation of Neurological Societies","volume":"71","author":"Gronseth","year":"2008"},{"key":"b17-jns10142","series-title":"Neurosurgery","first-page":"477","article-title":"Microvascular decompression for trigeminal neuralgia in the elderly: long-term treatment outcome and comparison with younger patients","volume":"65","author":"G\u00fcnther","year":"2009"},{"key":"b18-jns10142","series-title":"Neurosurgery","first-page":"494","article-title":"Repeat radiosurgery for refractory trigeminal neuralgia","volume":"50","author":"Hasegawa","year":"2002"},{"key":"b19-jns10142","series-title":"Int J Radiat Oncol Biol Phys","first-page":"112","article-title":"Repeat gamma knife radiosurgery for refractory or recurrent trigeminal neuralgia: treatment outcomes and quality-of-life assessment","volume":"59","author":"Herman","year":"2004"},{"key":"b20-jns10142","series-title":"J Neurosurg","first-page":"617","article-title":"Editorial. Results of microvascular decompression for trigeminal neuralgia","volume":"110","author":"Heros","year":"2009"},{"key":"b21-jns10142","series-title":"Neurology","first-page":"520","article-title":"Microvascular decompression for trigeminal neuralgia in patients over 70 years of age","volume":"60","author":"Javadpour","year":"2003"},{"key":"b22-jns10142","series-title":"Minim Invasive Neurosurg","first-page":"92","article-title":"Microvascular decompression as treatment of trigeminal neuralgia in the elderly patient","volume":"42","author":"J\u00f6dicke","year":"1999"},{"key":"b23-jns10142","series-title":"Ann Neurol","first-page":"89","article-title":"Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945\u20131984","volume":"27","author":"Katusic","year":"1990"},{"key":"b24-jns10142","series-title":"Neuroepidemiology","first-page":"276","article-title":"Epidemiology and clinical features of idiopathic trigeminal neuralgia and glossopharyngeal neuralgia: similarities and differences, Rochester, Minnesota, 1945\u20131984","volume":"10","author":"Katusic","year":"1991"},{"key":"b25-jns10142","series-title":"J Neurosurg","first-page":"479","article-title":"Trigeminal neuralgia treated by radiofrequency coagulation","volume":"59","author":"Latchaw","year":"1983"},{"issue":"Suppl","key":"b26-jns10142","series-title":"J Neurosurg","first-page":"160","article-title":"A prospective cohort study of microvascular decompression and Gamma Knife surgery in patients with trigeminal neuralgia","volume":"109","author":"Linskey","year":"2008"},{"key":"b27-jns10142","series-title":"J Neurosurg","first-page":"1","article-title":"Microvascular decompression of cranial nerves: lessons learned after 4400 operations","volume":"90","author":"McLaughlin","year":"1999"},{"key":"b28-jns10142","series-title":"J Neurosurg","first-page":"1231","article-title":"Classification of trigeminal neuralgia: clinical, therapeutic, and prognostic implications in a series of 144 patients undergoing microvascular decompression. Clinical article","volume":"111","author":"Miller","year":"2009"},{"key":"b29-jns10142","series-title":"J Neurosurg","first-page":"620","article-title":"Predictors of long-term success after microvascular decompression for trigeminal neuralgia","volume":"110","author":"Miller","year":"2009"},{"key":"b30-jns10142","series-title":"Gerontology","first-page":"1","article-title":"Neurosurgery for the elderly: facts and figures","volume":"42","author":"O'Brien","year":"1996"},{"key":"b31-jns10142","series-title":"Br J Neurosurg","first-page":"23","article-title":"Microvascular decompression for trigeminal neuralgia: report of outcome in patients over 65 years of age","volume":"14","author":"Ogungbo","year":"2000"},{"key":"b32-jns10142","series-title":"Clin J Pain","first-page":"317","article-title":"A prospective cost-effectiveness study of trigeminal neuralgia surgery","volume":"21","author":"Pollock","year":"2005"},{"key":"b33-jns10142","series-title":"Int J Radiat Oncol Biol Phys","first-page":"192","article-title":"Repeat radiosurgery for idiopathic trigeminal neuralgia","volume":"61","author":"Pollock","year":"2005"},{"key":"b34-jns10142","series-title":"Acta Neurochir (Wien)","first-page":"31","article-title":"Recurrent trigeminal cistern glycerol injections for tic douloureux","volume":"90","author":"Rappaport","year":"1988"},{"key":"b35-jns10142","series-title":"Neurol Med Chir (Tokyo)","first-page":"226","article-title":"Neurovascular decompression for trigeminal neuralgia in elderly patients","volume":"39","author":"Ryu","year":"1999"},{"key":"b36-jns10142","series-title":"Neurosurgery","first-page":"93","article-title":"Effect of microvascular decompression in trigeminal neuralgia patients with or without constant pain","volume":"63","author":"Sandell","year":"2008"},{"key":"b37-jns10142","series-title":"J Neurosurg","article-title":"Microvascular decompression after failed Gamma Knife radiosurgery for trigeminal neuralgia: a safe and effective rescue therapy? Clinical article","author":"Sekula"},{"key":"b38-jns10142","series-title":"J Neurosurg","first-page":"689","article-title":"Microvascular decompression for trigeminal neuralgia in elderly patients","volume":"108","author":"Sekula","year":"2008"},{"key":"b39-jns10142","series-title":"Acta Neurochir (Wien)","first-page":"1235","article-title":"Micro-vascular decompression for primary Trigeminal Neuralgia (typical or atypical). Long-term effectiveness on pain; prospective study with survival analysis in a consecutive series of 362 patients","volume":"148","author":"Sindou","year":"2006"},{"key":"b40-jns10142","series-title":"J Neurosurg","first-page":"527","article-title":"Predictors of outcome in surgically managed patients with typical and atypical trigeminal neuralgia: comparison of results following microvascular decompression","volume":"96","author":"Tyler-Kabara","year":"2002"},{"key":"b41-jns10142","series-title":"Neurol India","first-page":"36","article-title":"Repeat gamma knife radiosurgery for recurrent or refractory trigeminal neuralgia","volume":"56","author":"Wang","year":"2008"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/114\/1\/article-p172.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/114\/1\/article-p172.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/114\/1\/article-p172.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T02:00:27Z","timestamp":1679882427000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/114\/1\/article-p172.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2011,1]]},"references-count":41,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2010.6.jns10142","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,1]]}}}