{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:48:01Z","timestamp":1792176481986,"version":"4.4.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Common surgical treatments for trigeminal neuralgia (TN) include microvascular decompression (MVD), stereotactic radiosurgery (SRS), and radiofrequency ablation (RFA). Although the efficacy of each procedure has been described, few studies have directly compared these treatment modalities on pain control for TN. Using a large prospective longitudinal database, the authors aimed to 1) directly compare long-term pain control rates for first-time surgical treatments for idiopathic TN, and 2) identify predictors of pain control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors reviewed a prospectively collected database for all patients who underwent treatment for TN between 1997 and 2014 at the University of California, San Francisco. Standardized collection of data on preoperative clinical characteristics, surgical procedure, and postoperative outcomes was performed. Data analyses were limited to those patients who received a first-time procedure for treatment of idiopathic TN with &gt; 1 year of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of 764 surgical procedures performed at the University of California, San Francisco, for TN (364 SRS, 316 MVD, and 84 RFA), 340 patients underwent first-time treatment for idiopathic TN (164 MVD, 168 SRS, and 8 RFA) and had &gt; 1 year of follow-up. The analysis was restricted to patients who underwent MVD or SRS. Patients who received MVD were younger than those who underwent SRS (median age 63 vs 72 years, respectively; p &lt; 0.001). The mean follow-up was 59 \u00b1 35 months for MVD and 59 \u00b1 45 months for SRS. Approximately 38% of patients who underwent MVD or SRS had &gt; 5 years of follow-up (60 of 164 and 64 of 168 patients, respectively). Immediate or short-term (&lt; 3 months) postoperative pain-free rates (Barrow Neurological Institute Pain Intensity score of I) were 96% for MVD and 75% for SRS. Percentages of patients with Barrow Neurological Institute Pain Intensity score of I at 1, 5, and 10 years after MVD were 83%, 61%, and 44%, and the corresponding percentages after SRS were 71%, 47%, and 27%, respectively. The median time to pain recurrence was 94 months (25th\u201375th quartiles: 57\u2013131 months) for MVD and 53 months (25th\u201375th quartiles: 37\u201369 months) for SRS (p = 0.006). A subset of patients who had MVD also underwent partial sensory rhizotomy, usually in the setting of insignificant vascular compression. Compared with MVD alone, those who underwent MVD plus partial sensory rhizotomy had shorter pain-free intervals (median 45 months vs no median reached; p = 0.022). Multivariable regression demonstrated that shorter preoperative symptom duration (HR 1.005, 95% CI 1.001\u20131.008; p = 0.006) was associated with favorable outcome for MVD and that post-SRS sensory changes (HR 0.392, 95% CI 0.213\u20130.723; p = 0.003) were associated with favorable outcome for SRS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>In this longitudinal study, patients who received MVD had longer pain-free intervals compared with those who underwent SRS. For patients who received SRS, postoperative sensory change was predictive of favorable outcome. However, surgical decision making depends upon many factors. This information can help physicians counsel patients with idiopathic TN on treatment selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2016.9.jns16149","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T09:59:50Z","timestamp":1487930390000},"page":"68-77","source":"Crossref","is-referenced-by-count":91,"title":["Prospective comparison of long-term pain relief rates after first-time microvascular decompression and stereotactic radiosurgery for trigeminal neuralgia"],"prefix":"10.3171","volume":"128","author":[{"given":"Doris D.","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal P.","family":"Raygor","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tene A.","family":"Cage","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariann M.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Westcott","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas M.","family":"Barbaro","sequence":"additional","affiliation":[{"name":"Deparment of Neurological Surgery, Indiana University, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns16149","series-title":"Neurosurgery","first-page":"39","article-title":"Trigeminal numbness and tic relief after microvascular decompression for typical trigeminal neuralgia","volume":"40","author":"Barker FG II,","year":"1997","unstructured":"Barker FG II, Jannetta PJ, Bissonette DJ, Jho HD: Trigeminal numbness and tic relief after microvascular decompression for typical trigeminal neuralgia. 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