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Microvascular decompression for trigeminal neuralgia caused by vertebrobasilar dolichoectasia: interposition technique versus transposition technique

  • Original Article - Functional Neurosurgery - Pain
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Abstract

Background

Various techniques of microvascular decompression have been proposed for trigeminal neuralgia (TN) caused by vertebrobasilar dolichoectasia (VBD) with two main modalities: interposition and transposition. This retrospective study compares the outcomes of two techniques belonging to different modalities for VBD-associated TN.

Methods

From January 2011 to April 2017, 39 patients underwent MVD for VBD-associated TN. The transposition method chosen was the biomedical glue sling technique. Patients were divided into the interposition group (n = 16) and the transposition group (n = 23). The radiologic data, intraoperative findings, complications, and outcomes were analyzed.

Results

The 1-, 3-, and 5-year pain-free (BNI class I) maintenance rates were 100.0, 91.1, and 91.1%, respectively, in the transposition group and 87.5, 74.5, and 58.7% in the interposition group (p = 0.032). Postoperative complications were similar in both groups, but there was a trend for higher incidence of postoperative facial hypoesthesia using the interposition technique (p = 0.06).

Conclusion

In cases of VBD-associated TN, the transposition technique using biomedical glue was superior to the traditional interposition technique in maintaining a pain-free status, with no increase in the incidence of complication.

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Authors and Affiliations

  1. Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue No.1277, Wuhan, 430022, China

    Songshan Chai, Hao Xu, Qiangping Wang, Junjun Li, Jiajing Wang, Yihao Wang, Minhua Lin & Nanxiang Xiong

  2. Department of Neurosurgery, General Hospital of the Yangtze River Shipping, Wu Han Brain Hospital, Wuhan, China

    Hao Xu

  3. Department of International Education, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

    Hendrik Pool

  4. Department of Neurosurgery, Zhongnan Hospital of Wuhan University, No.169, Donghu Road, Wuhan, 430071, Hubei, China

    Nanxiang Xiong

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  1. Songshan Chai
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Contributions

Study conception and design: Songshan Chai, Qiangping Wang, and Nanxiang Xiong.

Data acquisition: Hao Xu and Junjun Li.

Data analysis and interpretation: Hao Xu, Jiajing Wang, and Yihao Wang.

Manuscript drafting: Songshan Chai and Nanxiang Xiong.

Critical revision of the manuscript: Hendrik Pool and Minhua Lin.

Reviewed final version of the manuscript and approved it for submission: all authors.

Corresponding authors

Correspondence to Minhua Lin or Nanxiang Xiong.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Chai, S., Xu, H., Wang, Q. et al. Microvascular decompression for trigeminal neuralgia caused by vertebrobasilar dolichoectasia: interposition technique versus transposition technique. Acta Neurochir 162, 2811–2821 (2020). https://doi.org/10.1007/s00701-020-04572-7

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  • DOI: https://doi.org/10.1007/s00701-020-04572-7

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