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Prognostic nomogram for percutaneous balloon compression in the treatment of trigeminal neuralgia

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Abstract

Because of its convenience and safety, percutaneous balloon compression (PBC) has become a more popular remedy for trigeminal neuralgia (TN) recently. The objective of this study was to establish a nomogram that can be used to preoperatively prognosticate the likelihood of pain-free based on preoperative disease characteristics. Clinical data were collected from those TN cases who had undergone PBC during the period of 2015 and 2020 in Qingdao Municipal Hospital. We excluded the cases caused by space-occupying lesion or had undergone MVD, percutaneous glycerol rhizotomy (PGR), and glycerol rhizotomy (GR). A nomogram was established based on the results of multivariable logistic analysis. A receiver operating characteristic curve (ROC) analysis was applied to evaluate the reliability of models. The plotted decision curves were also used to assess the net benefit of nomogram-assisted decisions. Internal validation was performed using the ROC by bootstrap sampling. Finally, 16 cases and 69 cases were included into the ineffective and effective groups respectively. In the crude, adjust I and adjust II models, response to carbamazepine positively, the grade II or III compression severity score, and classical TN type were all considered to be significant predictors of pain relief (BNI grades I–III) at 3 months’ follow-up. The AUC, accuracy, specificity, and sensitivity of the nomogram system were 0.83, 0.85, 0.75, and 0.87 respectively for predicting patient outcomes. The decision curves showed good performance for the nomogram system in terms of clinical application, while more research with validation in multiple, external independent patient populations is needed.

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Data Availability (data transparency)

Not applicable

Code availability (software application or custom code)

Data were analyzed with the use of the statistical packages R (The R Foundation; http://www.r-project.org; version 3.4.3) and Empower (R) (www.empowerstats.com, X&Y solutions, Inc., Boston, MA).

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Funding

This work was supported by the China’s government under grant of National Natural Science Foundation (#82001184).

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Authors and Affiliations

  1. Department of Neurosurgery, Qingdao Municipal Hospital, No.1 Jiaozhou Rd, Qingdao City, 266000, China

    Mingxing Liu, Siwei Tang, Tong Li, Zhiming Xu, Shengli Li, Yong Zhou, Luo Li & Weimin Wang

  2. Department of Pathology, Tongji Hospital, Shanghai Tongji University, 389 Xincun Rd, Shanghai, 200092, China

    Juanhong Shi

  3. Department of Orthopedic, Taizhou First People‘s Hospital, Wenzhou Medical University, Taizhou, 318020, Zhejiang Province, China

    Wei Shi

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  1. Mingxing Liu
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  2. Siwei Tang
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  3. Tong Li
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  9. Juanhong Shi
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  10. Wei Shi
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Contributions

All authors take responsibility for the integrity and the accuracy of this manuscript. Study concept and design: WW and LL; draft of the manuscript: ML, ST, and TL; acquisition of data: YZ and SL; statistical analysis: ZX; edit: WW; revised: JS and WS.

Corresponding authors

Correspondence to Luo Li, Weimin Wang, Juanhong Shi or Wei Shi.

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Liu, M., Tang, S., Li, T. et al. Prognostic nomogram for percutaneous balloon compression in the treatment of trigeminal neuralgia. Neurosurg Rev 45, 561–569 (2022). https://doi.org/10.1007/s10143-021-01514-4

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  • DOI: https://doi.org/10.1007/s10143-021-01514-4

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