Evidence map›Paper›PMID 38907766›Full record

ArticleNeurosurgical review2024

A history of stereotactic radiosurgery may predict failure of procedure following percutaneous glycerol rhizotomy for trigeminal neuralgia.

Sumil K Nair, Hyun Jong Oh, Anita Kalluri, Nna-Emeka Ejimogu, Hussain Al-Khars, Mostafa Abdulrahim, Yuanxuan Xia, Vivek Yedavalli, Christopher M Jackson, Judy Huang and 3 more

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Article in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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13 authors.

Sumil K NairDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Hyun Jong OhDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Anita KalluriDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Nna-Emeka EjimoguDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Hussain Al-KharsDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Mostafa AbdulrahimDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Yuanxuan XiaDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Vivek YedavalliDepartment of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Christopher M JacksonDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Judy HuangDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Michael LimDepartment of Neurosurgery, Stanford University School of Medicine, Palo Alto, CA, USA.
Chetan BettegowdaDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA.
Risheng XuDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St. Zayed Tower 6-6132, Baltimore, MD, 21287, USA. rxu4@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBoth stereotactic radiosurgery (SRS) and percutaneous glycerol rhizotomy are excellent options to treat TN in patients unable to proceed with microvascular decompression. However, the influence of prior SRS on pain outcomes following rhizotomy is not well understood.

methodsWe retrospectively reviewed all patients undergoing percutaneous rhizotomy at our institution from 2011 to 2022. Only patients undergoing percutaneous glycerol rhizotomy following SRS (SRS-rhizotomy) or those undergoing primary glycerol rhizotomy were considered. We collected basic demographic, clinical, and pain characteristics for each patient. Additionally, we characterized pain presentation and perioperative complications. Immediate failure of procedure was defined as presence of TN pain symptoms within 1-week of surgery, and short-term failure was defined as presence of TN pain symptoms within 3-months of surgery. A multivariate logistic regression model was used to evaluate the relationship of a history SRS and failure of procedure following percutaneous glycerol rhizotomy.

resultsOf all patients reviewed, 30 had a history of SRS prior to glycerol rhizotomy whereas 371 underwent primary percutaneous glycerol rhizotomy. Patients with a history of SRS were more likely to endorse V3 pain symptoms, p = 0.01. Additionally, patients with a history of SRS demonstrated higher preoperative BNI pain scores, p = 0.01. Patients with a history of SRS were more likely to endorse preoperative numbness, p < 0.0001. A history of SRS was independently associated with immediate failure [OR = 5.44 (2.06-13.8), p < 0.001] and short-term failure of glycerol rhizotomy [OR = 2.41 (1.07-5.53), p = 0.03]. Additionally, increasing age was found to be associated with lower odds of short-term failure of glycerol rhizotomy [OR = 0.98 (0.97-1.00), p = 0.01]

conclusionsA history of SRS may increase the risk of immediate and short-term failure following percutaneous glycerol rhizotomy. These results may be of use to patients who are poor surgical candidates and require multiple noninvasive/minimally invasive options to effectively manage their pain.

Indexed as

GlycerolRadiosurgeryRhizotomyTreatment FailureTrigeminal NeuralgiaAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeGlycerolFailurePainPercutaneous rhizotomyStereotactic radiosurgeryTrigeminal neuralgia

Identifiers

PMID38907766

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.