目的:接受三叉神经痛(TN)经皮神经根切断术的患者可能需要多种手术来控制疼痛。然而,目前尚不完全了解重复手术是否会影响术后并发症发生率.
方法:我们回顾性回顾了2011年至2022年在我们机构接受根茎切开术的患者。仅在没有包括微血管减压术(MVD)或放射外科在内的先前干预史的情况下,才包括患者。我们收集了基线患者信息,疼痛的特点,以及每位患者的术后并发症。将患者分为接受原发性根茎切开术和接受重复根茎切开术的患者。术后并发症的潜在驱动因素包括在多变量逻辑回归模型中。
结果:在审查的1904例病例中,965符合我们的纳入标准。392例患者接受了原发性神经根切断术,573例患者接受了重复根瘤术。重复根茎切断术组明显年龄较大,p<0.001。重复神经根切断术组患者双侧疼痛的频率较高,p=0.01。重复脊神经切断术组患者术前麻木和术后麻木的发生率明显较高,p<0.001。单根切断术和重复根切断术组之间的任何考虑的并发症均无显着差异。在多元逻辑回归中,重复根茎切开术并不能预测术后并发症的风险增加,p=0.14。
结论:再次行脊神经根切断术的患者可能存在术后麻木的风险,但术后并发症的风险并未增加。这些结果对手术不良的患者有用,因此,随着时间的推移,可能需要多次根茎切开术来有效地控制疼痛。
OBJECTIVE: Patients undergoing percutaneous
rhizotomy for trigeminal neuralgia (TN) may require several procedures to manage their pain. However, it is not fully understood whether repeat procedures influence postoperative complication rates.
METHODS: We retrospectively reviewed patients undergoing rhizotomy at our institution from 2011 to 2022. Patients were included only if they had no history of prior interventions including microvascular decompression (MVD) or radiosurgery. We collected baseline patient information, pain characteristics, and postoperative complications for each patient. Patients were dichotomized into those undergoing primary
rhizotomy versus those undergoing a repeat
rhizotomy. Potential drivers of postoperative complications were included in a multivariate logistic regression model.
RESULTS: Of the 1904 cases reviewed, 965 met our inclusion criteria. 392 patients underwent primary rhizotomy, and 573 patients underwent repeat rhizotomies. The repeat
rhizotomy group was significantly older, p<0.001. Patients in the repeat
rhizotomy group expressed higher frequencies of bilateral pain, p=0.01. Patients in the repeat rhizotomy group demonstrated a significantly higher rate of preoperative numbness and postoperative numbness, p<0.001. There were no significant differences in any of the considered complications between the single rhizotomy and repeat
rhizotomy groups. On multivariate logistic regression, repeat rhizotomy did not predict an increased risk of any postoperative complications, p=0.14.
CONCLUSIONS: Patients undergoing repeat rhizotomy may be at risk of postoperative numbness but are not at increased risk for postoperative complications. These results are of use to patients who are poor surgical candidates, and thus may require multiple rhizotomies to effectively manage their pain over time.