Clinical outcomes of partial sensory root rhizotomy on patients with recurrence of multiple sclerosing trigeminal neuralgia after percutaneous balloon compression

Objective: To investigate the clinical outcomes of partial sensory root rhizotomy (PSR) on patients with recurrence of multiple sclerosing trigeminal neuralgia(TN-MS) after percutaneous balloon compression (PBC).

Methods: 21 patients with recurrence of TN-MS after PBC were treated with PSR between January 2012 and July 2018. The visual analogue score (VAS) of participants before and after PBC/PSR were observed, and the postoperative recurrence rate of PBC/PSR were recorded, and the postoperative complications were also followed up.

Results: The VAS score reducing to 0-3 points after treatment was defined as effective and ≥4 points as invalid or recurrence. The effective rates of PSR at 1 day, 6 months, 12 months and 18 months after operation were 100%, 100%, 95% and 81%, respectively. The VAS scores of participants after PBC/PSR were significantly lower than those before PBC/PSR (all P<0.05), and the VAS scores at 1 day, 6 months, 12 months and 18 months after PSR were lower than those after PBC (all P<0.05). The postoperative recurrence rates at 6 months, 12 months and 18 months after PSR were significantly lower than those after PBC (all P<0.05). After PSR, all 21 patients had facial sensation loss, and one patient had intracranial infection, and none occurred decrease in masticatory muscle strength, weakened corneal reflex, intracranial hemorrhage, facial paralysis and cerebrospinal fluid leakage.

Conclusion: PSR had a lower pain recurrence rate and a more significant reduction in VAS score compared with PBC, and it could be recommended to treat patients with recurrence of TN-MS after PBC.