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Effectiveness of percutaneous balloon compression (PBC) in improving physical function and quality of life in trigeminal neuralgia: a retrospective study

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Abstract

Objective

To evaluate the effectiveness of percutaneous balloon compression (PBC) in treating trigeminal neuralgia (TN) and determine improvements in quality of life (QoL) and daily functional status.

Methods

Data from primary TN (pTN) patients treated with PBC from December 2018 to April 2021 were retrospectively analyzed. Short-Form 36 (SF-36) Health Survey and Functional Independence Measure (FIM) assessments were used to evaluate patients’ QoL and physical function every 6 months after surgery, and facial pain was evaluated every 3 to 6 months post-surgery.

Results

A total of 80 pTN patients were enrolled for analysis. The Barrow Neurological Institute (BNI) scores of I-II were achieved in 67 (83.8%) patients immediately after the surgery. The estimated rates of BNI I-II pain relief at one, two, and three years were 94.2%, 87.6%, and 83.2%, respectively. All aspects of the SF-36 questionnaire were significantly improved after the PBC, especially in terms of role physical (RP), bodily pain (BP), and social functioning (SF). Patients’ functional outcomes measured by FIM at the 6-month follow-up examination were 108.6 ± 9.9, which was significantly improved compared with the pretreatment scores (90.8 ± 12.7). There was no difference between the severity of facial numbness in FIM and any item of the SF-36 except RP (P = 0.004) at 6 months after surgery. There was also no difference in SF-36 and FIM between patients with or without facial hyperalgesia.

Conclusions

PBC can produce long-term and stable pain relief and significantly improve the patient’s QoL and physical function. However, further well-designed, high-level, evidence-based studies are needed to precisely assess the efficacy of PBC for pTN patients.

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Data Availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions

Abbreviations

BNI:

Barrow Neurological Institute

TN:

trigeminal neuralgia

PBC:

percutaneous balloon compression

FO:

foramen ovale

MC:

Meckel’s cave

PTN:

primary trigeminal neuralgia

MRI:

magnetic resonance image

FIM:

functional independence measure score

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Author information

Author notes

  1. Peng Huang and Hong Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Anesthesiology and Pain, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

    Peng Huang, Hong Liu, Zhenxiu Liu, Liqun Huang, Min Lu, Lina Wang, Yaqiong Yu & Xiaohong Jin

Authors
  1. Peng Huang
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  2. Hong Liu
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Corresponding authors

Correspondence to Yaqiong Yu or Xiaohong Jin.

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Comments

The authors of this article analyzed the size of the trigeminal nerve root in a series of patients with trigeminal neuralgia (TN) and discovered a higher likelihood of successful pain relief with percutaneous balloon compression in those who exhibited asymmetry between the affected and unaffected sides.

It remains unclear if the observed correlation has anything to do with the underlying mechanism of pain or the specific way the balloon compression produces long-lasting pain relief in TN patients. It is conceivable that nerve asymmetry is the reason TN patients develop pain in the first place, but the asymmetry may also be a result of prolonged nerve malfunction in TN patients when the nerve atrophies due to vascular compression or subsequent focal demyelination.

I applaud the authors for their thorough analysis of their clinical series but feel that it would be too early to make any recommendations in terms of choice of treatment approach or its technical details based on preoperative nerve morphometry.

Konstantin Slavin,

Chicago, USA

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Huang, P., Liu, H., Liu, Z. et al. Effectiveness of percutaneous balloon compression (PBC) in improving physical function and quality of life in trigeminal neuralgia: a retrospective study. Acta Neurochir 165, 3905–3912 (2023). https://doi.org/10.1007/s00701-023-05823-z

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  • DOI: https://doi.org/10.1007/s00701-023-05823-z

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