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Papers of the Week

2022 Sep 09

Brain Sci



Surgical and Clinical Outcomes of Microvascular Decompression: A Comparative Study between Young and Elderly Patients.


Menna G, Rapisarda A, Izzo A, D'Ercole M, D'Alessandris Q G, Olivi A, Montano N
Brain Sci. 2022 Sep 09; 12(9).
PMID: 36138952.


Microvascular decompression (MVD) is the only etiological technique for the treatment of trigeminal neuralgia (TN). Whilst there is a consensus MVD is likely effective regardless of age, the elderly population is thought to be more prone to have a higher rate of surgical complication, morbidity, and mortality. The main objective of our single-center, retrospective study was to analyze the surgical and clinical outcomes of MVD in TN elderly patients. From a surgical series of patients with TN who had undergone MVD from April 2018 to April 2022, 76 patients who matched the inclusion criteria were divided into two groups: twenty-five (32.9%) patients were older than 65 years and included in the elderly group, while the remaining fifty-one (61.1%) patients were below 65 years included in the non-elderly one. There were no differences between the groups in terms of acute pain relief (APR), Barrow Neurological Index (BNI) at follow-up, complications, and recurrence rate. In multivariate analysis (Cox proportional hazards regression analysis) the presence of an offending artery with nerve root distortion/indentation emerged as the only independent prognostic factor for pain-free survival ( = 0.0001). Our data endorse MVD as a safe and effective surgical procedure also for elderly patients with TN.