{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:47:36Z","timestamp":1792176456694,"version":"4.4.0"},"reference-count":64,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Because of the frequent recurrence of pain for patients with trigeminal neuralgia (TN), many undergo repeat percutaneous rhizotomy. The aim of this study was to assess whether the use of radiofrequency thermocoagulation with glycerin rhizotomy (RFTC-GR) or GR alone in repeat rhizotomy procedures influences postoperative pain and numbness outcomes.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The electronic medical records of 465 patients with TN who underwent repeat rhizotomy at the authors\u2019 institution between 2011 and 2022 were reviewed. Patients were dichotomized by treatment type: RFTC-GR or GR. Baseline demographics, comorbidities, and clinical characteristics were collected. The primary outcomes measured were pain and numbness, preoperatively and postoperatively, using the modified Barrow Neurological Institute (BNI) pain intensity scale and the BNI facial numbness scale. To compare pain and numbness outcomes between the RFTC-GR and GR groups, Kaplan-Meier, multivariate ordinal regression, and Cox proportional hazards analyses were performed.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Preoperatively, patients who received RFTC-GR had higher BNI pain scores and lower BNI numbness scores than those who received GR alone. Postoperatively, patients in the RFTC-GR group had higher BNI numbness scores than patients in the GR group, but the RFTC-GR group had significantly less rhizotomy failure (defined as a BNI pain score > 3 within 90 days after surgery). Multivariate ordinal regression analysis determined that RFTC-GR was associated with higher BNI numbness scores at the time of pain recurrence or the final follow-up (p = 0.04). A Cox proportional hazards model demonstrated that glycerin-only rhizotomy was associated with greater risk of failure compared with RFTC-GR (p < 0.01).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n In this study, RFTC-GR caused greater postoperative numbness than GR alone, while reducing the risk of rhizotomy failure compared with GR. Thus, RFTC-GR could be a more appropriate repeat procedure for patients with minimal numbness preoperatively.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.6.focus25456","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:16:40Z","timestamp":1756729000000},"page":"E10","source":"Crossref","is-referenced-by-count":1,"title":["Radiofrequency thermocoagulation with glycerin rhizotomy compared with glycerin rhizotomy alone for pain improvement in repeat rhizotomy"],"prefix":"10.3171","volume":"59","author":[{"given":"Sai","family":"Chandan Reddy","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Seebald","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumil K.","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Kalluri","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emeka","family":"Ejimogu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepti","family":"Tantry","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xihang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussain","family":"Al-Khars","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Abdulrahim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanxuan","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Yedavalli","sequence":"additional","affiliation":[{"name":"Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chetan","family":"Bettegowda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risheng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"Cephalalgia","first-page":"648","article-title":"Trigeminal neuralgia \u2013 diagnosis and treatment","volume":"37","author":"Maarbjerg S","year":"2017","unstructured":"Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G. Trigeminal neuralgia \u2013 diagnosis and treatment. Cephalalgia. 2017;37(7):648\u2013657."},{"issue":"5","key":"b2","series-title":"Pract Neurol","first-page":"392","article-title":"Trigeminal neuralgia: a practical guide","volume":"21","author":"Lambru G","year":"2021","unstructured":"Lambru G, Zakrzewska J, Matharu M. Trigeminal neuralgia: a practical guide. Pract Neurol. 2021;21(5):392\u2013402."},{"issue":"2","key":"b3","series-title":"Ther Adv Neurol Disord","first-page":"107","article-title":"Treatment options in trigeminal neuralgia","volume":"3","author":"Obermann M","year":"2010","unstructured":"Obermann M. Treatment options in trigeminal neuralgia. Ther Adv Neurol Disord. 2010;3(2):107\u2013115."},{"issue":"Suppl 2","key":"b4","series-title":"Acta Clin Croat","first-page":"96","article-title":"Treatment options for trigeminal neuralgia","volume":"61","author":"Rado\u0161 I","year":"2022","unstructured":"Rado\u0161 I. Treatment options for trigeminal neuralgia. Acta Clin Croat. 2022;61(Suppl 2):96-102."},{"issue":"1","key":"b5","series-title":"Neurol Clin","first-page":"107","article-title":"Trigeminal neuralgia","volume":"41","author":"Allam AK","year":"2023","unstructured":"Allam AK, Sharma H, Larkin MB, Viswanathan A. Trigeminal neuralgia. Neurol Clin. 2023;41(1):107\u2013121."},{"issue":"4","key":"b6","series-title":"Pain Med","first-page":"807","article-title":"Percutaneous radiofrequency rhizotomy is equally effective for trigeminal neuralgia patients with or without neurovascular compression","volume":"23","author":"Kao CH","year":"2022","unstructured":"Kao CH, Lee MH, Yang JT, Tsai YH, Lin MHC. Percutaneous radiofrequency rhizotomy is equally effective for trigeminal neuralgia patients with or without neurovascular compression. Pain Med. 2022;23(4):807\u2013814."},{"issue":"5","key":"b7","series-title":"J Neurosurg","first-page":"1405","article-title":"Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study","volume":"132","author":"Staudt MD","year":"2020","unstructured":"Staudt MD, Joswig H, Pickett GE, MacDougall KW, Parrent AG. Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study. J Neurosurg. 2020;132(5):1405\u20131413."},{"issue":"3","key":"b8","series-title":"Neurosurgery","first-page":"524","article-title":"Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients","volume":"48","author":"Kanpolat Y","year":"2001","unstructured":"Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients. Neurosurgery. 2001;48(3):524\u2013534."},{"issue":"25","key":"b9","series-title":"Medicine (Baltimore)","first-page":"e29543","article-title":"Percutaneous radiofrequency trigeminal rhizotomy benefits in patients with refractory trigeminal neuralgia","volume":"101","author":"Yang CC","year":"2022","unstructured":"Yang CC, Lee MH, Yang JT, Percutaneous radiofrequency trigeminal rhizotomy benefits in patients with refractory trigeminal neuralgia. Medicine (Baltimore). 2022;101(25):e29543."},{"issue":"1","key":"b10","series-title":"J Neurosurg","first-page":"270","article-title":"Internal neurolysis versus intraoperative glycerin rhizotomy for trigeminal neuralgia","volume":"138","author":"Xu R","year":"2023","unstructured":"Xu R, Materi J, Raj D, Internal neurolysis versus intraoperative glycerin rhizotomy for trigeminal neuralgia. 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Br J Neurosurg. 2011;25(2):268\u2013272."},{"key":"b13","series-title":"World Neurosurg","first-page":"e128","article-title":"Association between radiofrequency rhizotomy parameters and duration of pain relief in trigeminal neuralgia patients with recurrent pain","volume":"129","author":"Xie E","year":"2019","unstructured":"Xie E, Garzon-Muvdi T, Bender M, Association between radiofrequency rhizotomy parameters and duration of pain relief in trigeminal neuralgia patients with recurrent pain. World Neurosurg. 2019;129:e128\u2013e133."},{"issue":"1","key":"b14","series-title":"J Back Musculoskelet Rehabil","first-page":"1","article-title":"Percutaneous radiofrequency rhizotomy for cervical zygapophyseal joint mediated neck pain: a retrospective review of outcomes in forty-four cases","volume":"29","author":"Duff P","year":"2016","unstructured":"Duff P, Das B, McCrory C. 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Neurosurgery. 2003;53(5):1164\u20131167."},{"issue":"3","key":"b22","series-title":"J Neurosurg","first-page":"633","article-title":"A racial analysis of pain outcomes following microvascular decompression for trigeminal neuralgia","volume":"139","author":"So RJ","year":"2023","unstructured":"So RJ, Kalluri AL, Storm K, A racial analysis of pain outcomes following microvascular decompression for trigeminal neuralgia. J Neurosurg. 2023;139(3):633\u2013639."},{"issue":"6","key":"b23","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","volume":"111","author":"Miller JP","year":"2009","unstructured":"Miller JP, Acar F, Burchiel KJ. Classification of trigeminal neuralgia: clinical, therapeutic, and prognostic implications in a series of 144 patients undergoing microvascular decompression. 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Neurosurg Clin N Am. 2016;27(3):277\u2013295."},{"issue":"2","key":"b28","series-title":"Stereotact Funct Neurosurg","first-page":"75","article-title":"Comparing percutaneous treatments of trigeminal neuralgia: 19 years of experience in a single centre","volume":"94","author":"Noorani I","year":"2016","unstructured":"Noorani I, Lodge A, Vajramani G, Sparrow O. Comparing percutaneous treatments of trigeminal neuralgia: 19 years of experience in a single centre. Stereotact Funct Neurosurg. 2016;94(2):75\u201385."},{"key":"b29","series-title":"Clin Neurol Neurosurg","first-page":"112","article-title":"Comparative safety and efficacy of percutaneous approaches for the treatment of trigeminal neuralgia: a systematic review and meta-analysis","volume":"182","author":"Texakalidis P","year":"2019","unstructured":"Texakalidis P, Xenos D, Tora MS, Wetzel JS, Boulis NM. 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Arch Neurol. 1987;44(4):379\u2013381."},{"key":"b32","series-title":"Neurosurgical and Medical Management of Pain: Trigeminal Neuralgia, Chronic Pain, and Cancer Pain.","first-page":"51","article-title":"Retrogasserian glycerol injection with or without radiofrequency electrocoagulation for trigeminal neuralgia","author":"Brisman R","year":"1989","unstructured":"Brisman R. Retrogasserian glycerol injection with or without radiofrequency electrocoagulation for trigeminal neuralgia. In: Neurosurgical and Medical Management of Pain: Trigeminal Neuralgia, Chronic Pain, and Cancer Pain.Springer;1989:51-56."},{"issue":"7","key":"b1","series-title":"Cephalalgia","first-page":"648","article-title":"Trigeminal neuralgia \u2013 diagnosis and treatment","volume":"37","author":"Maarbjerg S","year":"2017","unstructured":"Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G. Trigeminal neuralgia \u2013 diagnosis and treatment. 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Pain Med. 2022;23(4):807\u2013814."},{"issue":"5","key":"b7","series-title":"J Neurosurg","first-page":"1405","article-title":"Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study","volume":"132","author":"Staudt MD","year":"2020","unstructured":"Staudt MD, Joswig H, Pickett GE, MacDougall KW, Parrent AG. Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study. J Neurosurg. 2020;132(5):1405\u20131413."},{"issue":"3","key":"b8","series-title":"Neurosurgery","first-page":"524","article-title":"Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients","volume":"48","author":"Kanpolat Y","year":"2001","unstructured":"Kanpolat Y, Savas A, Bekar A, Berk C. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients. Neurosurgery. 2001;48(3):524\u2013534."},{"issue":"25","key":"b9","series-title":"Medicine (Baltimore)","first-page":"e29543","article-title":"Percutaneous radiofrequency trigeminal rhizotomy benefits in patients with refractory trigeminal neuralgia","volume":"101","author":"Yang CC","year":"2022","unstructured":"Yang CC, Lee MH, Yang JT, Percutaneous radiofrequency trigeminal rhizotomy benefits in patients with refractory trigeminal neuralgia. Medicine (Baltimore). 2022;101(25):e29543."},{"issue":"1","key":"b10","series-title":"J Neurosurg","first-page":"270","article-title":"Internal neurolysis versus intraoperative glycerin rhizotomy for trigeminal neuralgia","volume":"138","author":"Xu R","year":"2023","unstructured":"Xu R, Materi J, Raj D, Internal neurolysis versus intraoperative glycerin rhizotomy for trigeminal neuralgia. J Neurosurg. 2023;138(1):270\u2013275."},{"issue":"2","key":"b11","series-title":"Can J Neurol Sci","first-page":"137","article-title":"Long-term results after glycerol rhizotomy for multiple sclerosis-related trigeminal neuralgia","volume":"21","author":"Kondziolka D","year":"1994","unstructured":"Kondziolka D, Lunsford LD, Bissonette DJ. Long-term results after glycerol rhizotomy for multiple sclerosis-related trigeminal neuralgia. Can J Neurol Sci. 1994;21(2):137\u2013140."},{"issue":"2","key":"b12","series-title":"Br J Neurosurg","first-page":"268","article-title":"Percutaneous glycerol rhizotomy for trigeminal neuralgia: safety and efficacy of repeat procedures","volume":"25","author":"Harries AM","year":"2011","unstructured":"Harries AM, Mitchell RD. Percutaneous glycerol rhizotomy for trigeminal neuralgia: safety and efficacy of repeat procedures. 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Percutaneous radiofrequency rhizotomy for cervical zygapophyseal joint mediated neck pain: a retrospective review of outcomes in forty-four cases. J Back Musculoskelet Rehabil. 2016;29(1):1\u20135."},{"issue":"2","key":"b15","series-title":"Neurosurgery","first-page":"407","article-title":"Comparative evaluation of percutaneous retrogasserian glycerol rhizolysis and radiofrequency thermocoagulation techniques in the management of trigeminal neuralgia","volume":"70","author":"Udupi BP","year":"2012","unstructured":"Udupi BP, Chouhan RS, Dash HH, Bithal PK, Prabhakar H. Comparative evaluation of percutaneous retrogasserian glycerol rhizolysis and radiofrequency thermocoagulation techniques in the management of trigeminal neuralgia. 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