Evaluation of the Effectiveness of Trigeminal Ganglion Ablation Using Pulse Radiofrequency in the Treatment of Trigeminal Neuralgia

Abstract

Background: Trigeminal neuralgia is a sudden, severe condition characterized by stabbing and recurrent pain. Radiofrequency thermocoagulation (RFT) and pulsed radiofrequency (PRF) are common surgical interventions used to treat trigeminal neuralgia. This study aimed to investigate the therapeutic effects and associated complications of PRF in the treatment of trigeminal neuralgia.
 Methods: Pulsed radiofrequency was performed on 20 patients with primary trigeminal neuralgia. One months later, pain relief and complication status were evaluated. All patients who referred to the pain clinic of Amir Alam Hospital with a diagnosis of primary TN and after failure of conservative treatment or intolerance to drug side effects were candidates for trigeminal ganglion destruction by PRF method were the study population.
 Results: In this study, the female to male ratio was 1.5. The mean age of patients was 50.70 years. The highest prevalence was reported in 50-75 years (45%). 7 patients (35%) had pain in the right and 13 patients (65%) had pain in the left. In 18 patients there was involvement in one nerve root and in 2 patients there was involvement in 2 nerve roots. 1 patient (5%) had V1 root involvement, 13 patients (65%) had V2 root involvement and 8 patients (40%) had V3 root involvement. The mean pain score of patients before the procedure was 8.8. The mean pain of patients one hour after surgery was 3.95 and on days 7 and 30 after surgery were 3.3 and 4.25, respectively. One hour after the operation, effective pain relief was observed in 75% of patients. The effective response rate was observed one week after the procedure in 80% of patients and one month later in 60% of patients. There was no significant relationship between patients' gender and the effectiveness or ineffectiveness of the procedure after one month. With age, the effective response to treatment in patients increases. In 2 patients, infection was reported at the procedure site. Four patients reported paresthesia at the procedure site one month after surgery.
 Conclusion: PRF treatment was an effective, safe and non-destructive method for patients with TN. Primary PRF treatment can be considered as a first-line option before more invasive treatments, such as neurodegenerative procedures and MVD surgery.