Results of Percutaneous Balloon Compression in Trigeminal Pain Syndromes

Sanjeet S. Grewal, Panagiotis Kerezoudis, Oscar Garcia, Alfredo Quinones-Hinojosa, Ronald Reimer, Robert E. Wharen

Research output: Contribution to journalArticle

Abstract

Objective: To investigate initial pain relief and subsequent recurrence after percutaneous balloon compression (PBC) and describe its association with the nature of trigeminal pain, previous procedures, or other clinical factors. Methods: A total of 222 patients with medically refractory trigeminal pain treated with PBC at Mayo Clinic Florida between 1998 and 2017 were enrolled into this study. Patients were divided into those with typical trigeminal neuralgia (TN) and those with atypical trigeminal pain. The postprocedural rate of pain recurrence and associations between patient characteristics and recurrence were studied. Results: One hundred fifty-two patients had TN and 70 patients had atypical pain. At the last follow-up, 158 patients had excellent pain relief, 37 had good pain relief, 11 had fair pain relief, and 16 had poor pain relief. The median duration of follow-up was 31.1 months. Patients with atypical pain were less likely to have an excellent result compared with patients with typical pain (61.4% vs. 82.9%; P < 0.001). Recurrence was observed in 103 patients (46.4%) and was associated with previous procedures (hazard ratio, 1.658; 95% confidence interval, 1.09–2.49; P = 0.017). Other clinical factors were not significant. Conclusions: Our study demonstrates the safety and efficacy of PBC, with 88% of patients pain-free at last follow-up. Patients with atypical pain have worse outcomes, and patients with previous procedures have a higher risk of recurrence. Repeat surgery does not decrease efficacy. We recommend conservative parameter selection at the initial procedure.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Pain
Recurrence
Trigeminal Neuralgia
Intractable Pain
Reoperation
Confidence Intervals
Safety

Keywords

  • Atypical Pain
  • Balloon Compression
  • Trigeminal Neuralgia

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Results of Percutaneous Balloon Compression in Trigeminal Pain Syndromes. / Grewal, Sanjeet S.; Kerezoudis, Panagiotis; Garcia, Oscar; Quinones-Hinojosa, Alfredo; Reimer, Ronald; Wharen, Robert E.

In: World Neurosurgery, 01.01.2018.

Research output: Contribution to journalArticle

Grewal, Sanjeet S. ; Kerezoudis, Panagiotis ; Garcia, Oscar ; Quinones-Hinojosa, Alfredo ; Reimer, Ronald ; Wharen, Robert E. / Results of Percutaneous Balloon Compression in Trigeminal Pain Syndromes. In: World Neurosurgery. 2018.
@article{bb9348fefc304853aa0058fbb7961b7c,
title = "Results of Percutaneous Balloon Compression in Trigeminal Pain Syndromes",
abstract = "Objective: To investigate initial pain relief and subsequent recurrence after percutaneous balloon compression (PBC) and describe its association with the nature of trigeminal pain, previous procedures, or other clinical factors. Methods: A total of 222 patients with medically refractory trigeminal pain treated with PBC at Mayo Clinic Florida between 1998 and 2017 were enrolled into this study. Patients were divided into those with typical trigeminal neuralgia (TN) and those with atypical trigeminal pain. The postprocedural rate of pain recurrence and associations between patient characteristics and recurrence were studied. Results: One hundred fifty-two patients had TN and 70 patients had atypical pain. At the last follow-up, 158 patients had excellent pain relief, 37 had good pain relief, 11 had fair pain relief, and 16 had poor pain relief. The median duration of follow-up was 31.1 months. Patients with atypical pain were less likely to have an excellent result compared with patients with typical pain (61.4{\%} vs. 82.9{\%}; P < 0.001). Recurrence was observed in 103 patients (46.4{\%}) and was associated with previous procedures (hazard ratio, 1.658; 95{\%} confidence interval, 1.09–2.49; P = 0.017). Other clinical factors were not significant. Conclusions: Our study demonstrates the safety and efficacy of PBC, with 88{\%} of patients pain-free at last follow-up. Patients with atypical pain have worse outcomes, and patients with previous procedures have a higher risk of recurrence. Repeat surgery does not decrease efficacy. We recommend conservative parameter selection at the initial procedure.",
keywords = "Atypical Pain, Balloon Compression, Trigeminal Neuralgia",
author = "Grewal, {Sanjeet S.} and Panagiotis Kerezoudis and Oscar Garcia and Alfredo Quinones-Hinojosa and Ronald Reimer and Wharen, {Robert E.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.wneu.2018.03.111",
language = "English (US)",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Results of Percutaneous Balloon Compression in Trigeminal Pain Syndromes

AU - Grewal, Sanjeet S.

AU - Kerezoudis, Panagiotis

AU - Garcia, Oscar

AU - Quinones-Hinojosa, Alfredo

AU - Reimer, Ronald

AU - Wharen, Robert E.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objective: To investigate initial pain relief and subsequent recurrence after percutaneous balloon compression (PBC) and describe its association with the nature of trigeminal pain, previous procedures, or other clinical factors. Methods: A total of 222 patients with medically refractory trigeminal pain treated with PBC at Mayo Clinic Florida between 1998 and 2017 were enrolled into this study. Patients were divided into those with typical trigeminal neuralgia (TN) and those with atypical trigeminal pain. The postprocedural rate of pain recurrence and associations between patient characteristics and recurrence were studied. Results: One hundred fifty-two patients had TN and 70 patients had atypical pain. At the last follow-up, 158 patients had excellent pain relief, 37 had good pain relief, 11 had fair pain relief, and 16 had poor pain relief. The median duration of follow-up was 31.1 months. Patients with atypical pain were less likely to have an excellent result compared with patients with typical pain (61.4% vs. 82.9%; P < 0.001). Recurrence was observed in 103 patients (46.4%) and was associated with previous procedures (hazard ratio, 1.658; 95% confidence interval, 1.09–2.49; P = 0.017). Other clinical factors were not significant. Conclusions: Our study demonstrates the safety and efficacy of PBC, with 88% of patients pain-free at last follow-up. Patients with atypical pain have worse outcomes, and patients with previous procedures have a higher risk of recurrence. Repeat surgery does not decrease efficacy. We recommend conservative parameter selection at the initial procedure.

AB - Objective: To investigate initial pain relief and subsequent recurrence after percutaneous balloon compression (PBC) and describe its association with the nature of trigeminal pain, previous procedures, or other clinical factors. Methods: A total of 222 patients with medically refractory trigeminal pain treated with PBC at Mayo Clinic Florida between 1998 and 2017 were enrolled into this study. Patients were divided into those with typical trigeminal neuralgia (TN) and those with atypical trigeminal pain. The postprocedural rate of pain recurrence and associations between patient characteristics and recurrence were studied. Results: One hundred fifty-two patients had TN and 70 patients had atypical pain. At the last follow-up, 158 patients had excellent pain relief, 37 had good pain relief, 11 had fair pain relief, and 16 had poor pain relief. The median duration of follow-up was 31.1 months. Patients with atypical pain were less likely to have an excellent result compared with patients with typical pain (61.4% vs. 82.9%; P < 0.001). Recurrence was observed in 103 patients (46.4%) and was associated with previous procedures (hazard ratio, 1.658; 95% confidence interval, 1.09–2.49; P = 0.017). Other clinical factors were not significant. Conclusions: Our study demonstrates the safety and efficacy of PBC, with 88% of patients pain-free at last follow-up. Patients with atypical pain have worse outcomes, and patients with previous procedures have a higher risk of recurrence. Repeat surgery does not decrease efficacy. We recommend conservative parameter selection at the initial procedure.

KW - Atypical Pain

KW - Balloon Compression

KW - Trigeminal Neuralgia

UR - http://www.scopus.com/inward/record.url?scp=85045300399&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85045300399&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2018.03.111

DO - 10.1016/j.wneu.2018.03.111

M3 - Article

C2 - 29581020

AN - SCOPUS:85045300399

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

ER -