This study aimed to establish an effective prognostic nomogram for microvascular decompression (MVD)–treated trigeminal neuralgia (TN). The nomogram was based on a retrospective cohort study of 1054 patients with TN. During the period 2005–2014, 845 patients at our department treated TN with MVD and served as a development cohort. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. The model was externally validated by 209 TN patients during 2014–2016. Multivariate cox analysis suggested that the patient’s age, atypical pain, vascular type, number of offending vessels, and second MVD were significant factors influencing the prognosis of MVD-treated TN. The C index of nomogram in the development cohort was 0.767 (95% CI, 0.739–0.794), and 0.749 (95% CI, 0.688–0.810) in the validation cohort. We developed and validated a nomogram to predict 3-year overall remission rate after MVD treatment of TN. The nomogram can be used in clinical trials to determine the likelihood of pain recurrence in TN patients treated with MVD for 3 years to aid in the comprehensive treatment of TN.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Manzoni GC, Torelli P (2005) Epidemiology of typical and atypical craniofacial neuralgias. Neurol Sci 26:s65–s67
Dandy WE (1934) Concerning the cause of trigeminal neuralgia. Am J Surg 24:447–455
Barker FG, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD (1996) The long-term outcome of microvascular decompression for trigeminal neuralgia. Br J Neurosurg 24:18–25
Bederson JB, Wilson CB (1989) Evaluation of microvascular decompression and partial sensory rhizotomy in 252 cases of trigeminal neuralgia. J Neurosurg 71:359–367
Burchiel KJ, Clarke H, Haglund M, Loeser JD (1988) Long-term efficacy of microvascular decompression in trigeminal neuralgia. J Neurosurg 69:35
Walchenbach R, Voormolen JHC, Hermans J (1994) Microvascular decompression for trigeminal neuralgia: A critical reappraisal. Clin Neurol Neurosurg 96:290–295
Broggi G, Ferroli P, Franzini A, Servello D, Dones I (2000) Microvascular decompression for trigeminal neuralgia: comments on a series of 250 cases, including 10 patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 68:59–64
Oesman C, Mooij JJA (2011) Long-term follow-up of microvascular decompression for trigeminal neuralgia. Skull Base 21:313–322
Zhang WB, Min LZ, Tao BB, Sun QY, Li ST, Wang XQ (2020) Prognosis comparison of different branches of trigeminal neuralgia. World Neurosurg undefined:undefined
Hong W, Zheng X, Wu Z, Li X, Wang X, Li Y, Zhang W, Zhong J, Hua X, Li S (2011) Clinical features and surgical treatment of trigeminal neuralgia caused solely by venous compression. Acta Neurochir 153:1037
Theodosopoulos PV, Marco E, Applebury C, Lamborn KR, Wilson CB (2002) Predictive model for pain recurrence after posterior fossa surgery for trigeminal neuralgia. Arch Neurol 59:1297–1302
Tyler-Kabara EC, Kassam AB, Horowitz MH, Louise U, Constantinos H, Levy EI, Yue-Fang C (2002) Predictors of outcome in surgically managed patients with typical and atypical trigeminal neuralgia: comparison of results following microvascular decompression. J Neurosurg 96:527
Lucas JT, Jr., Nida AM, Isom S, Marshall K, Bourland JD, Laxton AW, Tatter SB, Chan MD (2014) Predictive nomogram for the durability of pain relief from gamma knife radiation surgery in the treatment of trigeminal neuralgia. Int J Radiat Oncol Biol Phys 89:120–126. https://doi.org/10.1016/j.ijrobp.2014.01.023
Burchiel K (2003) A New Classification for Facial Pain. Neurosurgery 53:1164–1166; discussion 1166. https://doi.org/10.1227/01.NEU.0000088806.11659.D8
Feng BH, Zheng XS, Liu M, Wang XQ, Wang XH, Ying TT, Li ST (2015) Microvascular Decompression for Trigeminal Neuralgia: Zone Exploration and Decompression Techniques. J Craniofac Surg 26:2381–2384. https://doi.org/10.1097/scs.0000000000002147
Rogers CL, Shetter AG, Fiedler JA, Smith KA, Han PP, Speiser BL (2000) Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute. Int J Radiat Oncol Biol Phys 47:1013–1019
Gardner WJ (1962) Concerning the mechanism of trigeminal neuralgia and hemifacial spasm. J Neurosurg 19:947–958
Jannetta PJ (1967) Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. 1967. J Neurosurg 26:159–162
Adams CB (1989) Microvascular compression: an alternative view and hypothesis. J Neurosurg 70:1–12
Barker FG 2nd, Jannetta PJ, Bissonette DJ, Jho HD (1997) Trigeminal numbness and tic relief after microvascular decompression for typical trigeminal neuralgia. Neurosurgery 40:39
Tronnier VM, Rasche D, Hamer J, Kienle AL, Kunze S (2001) Treatment of idiopathic trigeminal neuralgia: comparison of long-term outcome after radiofrequency rhizotomy and microvascular decompression. Pain Practice 1:382–383
Kalkanis SN, Eskandar EN, Carter BS, Barker FG (2003) Microvascular decompression surgery in the United States, 1996 to 2000: mortality rates, morbidity rates, and the effects of hospital and surgeon volumes. Am J Ophthalmol 136:1199–1200
Zhong J, Li ST, Zhu J, Guan HX, Zhou QM, Jiao W, Ying TT, Yang XS, Zhan WC, Hua XM (2012) A clinical analysis on microvascular decompression surgery in a series of 3000 cases. Clin Neurol Neurosurg 114:846–851. https://doi.org/10.1016/j.clineuro.2012.01.021
Lee S, Levy E, Am KA, Jannetta P (2000) Recurrent trigeminal neuralgia attributable to veins after microvascular decompression. Neurosurgery 46:356–361
Brian C (2004) Microvascular decompression for trigeminal neuralgia in the elderly: a review of the safety and efficacy. Neurosurgery 58:840–848
Hussain M, Konteas A, Sunderland G, Franceschini P, Byrne P, Farah J, Eldridge P (2018) Re-Exploration of Microvascular Decompression in Recurrent Trigeminal Neuralgia and Intraoperative Management Options. World Neurosurgery 117. https://doi.org/10.1016/j.wneu.2018.05.147
Quan DU, Wenhua YU, Zhu Q, Neurosurgery DO (2016) Microvascular decompression for elderly patients with trigeminal neuralgia. Zhejiang Med J 29:7–14
Li ST, Pan Q, Liu N, Shen F, Liu Z, Guan Y (2004) Trigeminal neuralgia: what are the important factors for good operative outcomes with microvascular decompression. Surg Neurol 62:400–404
Sindou M, Leston J, Decullier E, Chapuis F (2008) Microvascular decompression for primary trigeminal neuralgia: Long-term effectiveness and prognostic factors in a series of 362 consecutive patients with clear-cut neurovascular conflicts who underwent pure decompression. Journal of neurosurgery 107:1144–1153. https://doi.org/10.3171/JNS-07/12/1144
El-Ghandour NMF (2010) Microvascular decompression in the treatment of trigeminal neuralgia caused by vertebrobasilar ectasia. Neurosurgery 67:330
Xu Z, Zhang P, Long L, He H, Zhang J, Sun S (2016) Diabetes mellitus in classical trigeminal neuralgia: a predisposing factor for its development. Clin Neurol Neurosurg 151:70–72
Bick S, Huie D, Sneh G, Eskandar E (2018) Older Patients Have Better Pain Outcomes Following Microvascular Decompression for Trigeminal Neuralgia. Neurosurgery 84. https://doi.org/10.1093/neuros/nyy011
Tyler-Kabara E, Kassam A, Horowitz M, Urgo L, Hadjipanayis C, Levy E, Chang Y-F (2002) Predictors of outcome in surgically managed patients with typical and atypical trigeminal neuralgia: Comparison of results following microvascular decompression. Journal of neurosurgery 96:527–531. https://doi.org/10.3171/jns.2002.96.3.0527
The authors acknowledge the collaboration of all of the staff and technical members at Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Conflict of interest
The authors declare that they have no conflict of interest.
This study has been approved by the Institutional Ethics Committee of Xinhua Hospital and was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments. For this retrospective study, formal consent was not required.
Informed consent was obtained from all individual participants who were included in the study.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Wen-Bo Zhang, Ya-Ying Zeng, and Bo-Wen Chang are co-first authors to the article.
About this article
Cite this article
Zhang, WB., Zeng, YY., Chang, BW. et al. Prognostic nomogram for microvascular decompression–treated trigeminal neuralgia. Neurosurg Rev 44, 571–577 (2021). https://doi.org/10.1007/s10143-020-01251-0
- Trigeminal neuralgia
- Remission rate
- Microvascular decompression
- Predictive model