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KMID : 0614520030130010062
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Journal of the Korean Pain Research Society
2003 Volume.13 No. 1 p.62 ~ p.66
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Percutaneous Radiofrequency Thermal Rhizotomy for the Treatment of Intractable Trigeminal Neuralgia
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Lim Dong-Jun
Park Jung-Yul
Kim Sang-Dae
Ha Sung-Kon
Kim Se-Hoon
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Abstract
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The purpose of this study is to evaluate the effectiveness of radiofrequency thermal rhizotomy (RTR) for trigeminal neuralgia in patients refractory to extended period of conservative treatments. Thirty patients who underwent RTR between Jan. 1997- Dec. 2000 were evaluated. All patients had more than 6 months of intractable pain of trigeminal neuralgia refractory to conservative managements. These patients were characterized by age, sex, side of the face, and division(s) involved. The RTR of retrogassereian ganglion was done in usual fashion according to site(s) of corresponding branches of trigeminal nerves. Two thermocoagulation lesionings were performed after test stimulation and satisfactory results obtained. Postoperatively, patients were evaluated for pain relief, recurrence requiring reoperation as well as the type and rate of complication. Patients were categorized into groups; 1) successful result: excellent, good pain relief; and 2) unsuccessful result: fair, poor, or no pain relief. Follow-up ranged from 6 to 32 months (mean, 18 months) and results were evaluated at early and long- term follow-up. At early follow-up (defined as immediately postoperatively to 6 months), pain relief of excellent or good quality (successful result) was observed in 27 of 30 patients (90%). No pain relief was seen in one patient. At long-term follow-up, recurrence of pain that required reoperation was observed in three (10%) patients. Although postoperative dysesthesia developed in 6 (20%) patients, all except one required no extended medical management and were improved within several weeks. There were no mortalities and no significant morbidities related to the procedures. These procedures were done out-patient basis in sixteen patients but for those patients preferred in-patient basis, mean duration of stay was 3 days. On the basis of our experience and a review of the literature, we conclude that radiofrequency thermal rhizotomy provide successful pain relief, thus successful results, in most of patients without any significant side effects or complications. Thus, it may be considered a procedure of choice for most patients undergoing first surgical treatments.
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KEYWORD
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Radiofrequency, Rhizotomy, Thermocagulaion, Trigeminal neuralgia
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