{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:08:21Z","timestamp":1793660901013,"version":"4.5.1"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The objective was to evaluate the long-term outcome of microvascular decompression (MVD) utilizing autologous muscle for trigeminal neuralgia (TGN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective review was performed of all first-time MVD patients for typical classic TGN without prior surgical intervention who were treated between 2000 and 2019 at a tertiary supraregional neurosurgery practice. Demographic characteristics, surgical findings, operative results, complications, and recurrence rates at 1 year, 5 years, and last follow-up were collected. Pain outcome was assessed using the Barrow Neurological Institute (BNI) pain score. The chi-square test with continuity correction was used to compare categorical variables, and Kaplan-Meier curves and Cox regression were used to identify factors associated with recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In total, 1025 patients were studied with a median (interquartile range [IQR]) (range) follow-up of 8 (5\u201313) (3\u201320) years. In the immediate postoperative period, 889 patients (86.7%) had complete pain relief and 106 (10.3%) had partial pain relief; neither group required medication, and 30 patients (2.9%) had no relief. One hundred forty-one recurrences (13.8%) occurred over a median (IQR) of 3 (2\u20136) years after surgery. The proportion of patients without recurrence was 97% at 1 year, 90% at 5 years, 85% at 10 years, 82% at 15 years, and 81% at 20 years. There was no significant difference in the probability of recurrence between patients with complete (114\/907 [12.6%] recurrences) or partial (19\/106 [17.9%] recurrences) postoperative pain relief (p = 0.124, log-rank test). Patients with venous compression (n = 322) had a significantly higher rate of MVD failure (n = 16 [5%]) compared to those with arterial compression (14\/703 [2%]) (p = 0.015, chi-square test). In the Cox proportional hazards model, venous compression and lack of immediate postoperative pain relief had hazard ratios of 1.62 (95% CI 1.16\u20132.27) and 2.65 (95% CI 1.45\u20134.82) for recurrence, respectively. One hundred twenty-four (12.1%) complications were documented, including facial numbness (44 [4.3%]), facial nerve palsy (37 [3.6%]), CSF leak (13 [1.3%]), and diplopia (5 [0.5%]), which resolved in all patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>MVD with autologous muscle provides long-lasting pain relief in TGN patients with vascular compression with minimum morbidity and is a viable alternative to synthetic materials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.9.jns231473","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T21:29:21Z","timestamp":1712957361000},"page":"849-859","source":"Crossref","is-referenced-by-count":17,"title":["Long-term outcome of microvascular decompression for typical trigeminal neuralgia with autologous muscle: an analysis of 1025 patients from a developing country"],"prefix":"10.3171","volume":"141","author":[{"given":"Mohammad","family":"Ashraf","sequence":"first","affiliation":[{"name":"Wolfson School of Medicine, University of Glasgow & Queen Elizabeth University Hospital, Glasgow, United Kingdom;"},{"name":"Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan;"},{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fauzia","family":"Sajjad","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan;"},{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan;"},{"name":"Department of Neurosurgery, Services Institute of Medical Sciences, Lahore, Pakistan;"},{"name":"Department of Neurosurgery, Khawaja Safdar Medical College, Sialkot, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Shahzad","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan;"},{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huzaifa Ahmad","family":"Cheema","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundus","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hira","family":"Umar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Services Institute of Medical Sciences, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conor S.","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umar","family":"Faiz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Khawaja Safdar Medical College, Sialkot, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abia","family":"Shahid","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Akmal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan;"},{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveed","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan;"},{"name":"Department of Neurosurgery, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Eur J Neurol","first-page":"831","article-title":"European Academy of Neurology guideline on trigeminal neuralgia","volume":"26","author":"Bendtsen L","year":"2019","unstructured":"Bendtsen L, Zakrzewska JM, Abbott J,  European Academy of Neurology guideline on trigeminal neuralgia. 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