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Working ability and use of healthcare resources for patients with trigeminal neuralgia treated via microvascular decompression

  • Original Article - Neurosurgery general
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Abstract

Background

Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing and recurrent episodes of pain in one or more branches of the trigeminal nerve. In patients with TN refractory to medical therapy, microvascular decompression (MVD) is considered. TN interferes with daily functioning and is associated with depression and anxiety. Direct costs of MVD are high, but the procedure is believed to improve working ability and reduce the use of medical resources. This study aims to analyse MVD’s effects on TN patients regarding work capacity, healthcare utilisation and health-related quality of life (hrQoL).

Methods

We conducted a cross-sectional survey of patients who underwent MVD for TN between 2007 and 2016 (n = 46). The patients’ outcome, work capacity and use of medical resources were assessed via the Barrow Neurological Institute Pain Intensity Score (BNI Score), with questions regarding patients’ employment status, restrictions in work capacity, healthcare utilisation and completion of the EQ5D questionnaire.

Results

The response rate was 28/46 (61%). The majority of the participants (20/28) reported feeling strongly/quite handicapped in productivity due to TN preoperatively, which was also indicated by a few participants (3/28) postoperatively (p = < 0.01). Pain-related days off work were reduced postoperatively from 21 to 4 (p = 0.059) on average. Postoperative hrQoL did not differ from the general German population. Further reductions in healthcare utilisation and private costs were shown.

Conclusion

In TN, MVD alleviates patient burden, especially concerning productivity and the consumption of health resources.

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Abbreviations

BNI Score:

Barrow Neurological Institute Pain Intensity Score

hrQoL:

Health-related quality of life

FU:

Follow-up

OPS:

German procedure classification (Operationen und Prozeduren Schlüssel)

MS:

Multiple sclerosis

MVD:

Microvascular decompression

TN:

Trigeminal neuralgia

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Authors and Affiliations

  1. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany

    Kathrin Obermueller, Ehab Shiban, Thomas Obermueller & Bernhard Meyer

  2. Institute for Medical Information Processing, Biometrics and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany

    Kathrin Obermueller

  3. Department of Neurosurgery, Klinikum Bogenhausen, Engelschalkingerstrasse 77, 81925, Munich, Germany

    Jens Lehmberg

Authors
  1. Kathrin Obermueller
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  2. Ehab Shiban
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  3. Thomas Obermueller
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  4. Bernhard Meyer
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  5. Jens Lehmberg
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Corresponding author

Correspondence to Kathrin Obermueller.

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Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

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This article is part of the Topical Collection on Neurosurgery general

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Obermueller, K., Shiban, E., Obermueller, T. et al. Working ability and use of healthcare resources for patients with trigeminal neuralgia treated via microvascular decompression. Acta Neurochir 160, 2521–2527 (2018). https://doi.org/10.1007/s00701-018-3695-5

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  • DOI: https://doi.org/10.1007/s00701-018-3695-5

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