ArticlePain medicine (Malden, Mass.)2026
Intraoperative computed tomography-guided neuronavigation for radiofrequency rhizotomy in trigeminal neuralgia: optimizing cannulation trajectories for individual anatomy.
Article in Pain medicine (Malden, Mass.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- [Novel framework based on multi-stage random sampling and differentiable rendering for automated three-dimensional orientation estimation of skull base foramina].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2026Article
- Hybrid fluoroscopy-neuronavigation technique for percutaneous balloon compression in trigeminal neuralgia: how I do it.Acta neurochirurgica · 2026Article
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Abstract
objectiveFluoroscopy-guided radiofrequency rhizotomy for trigeminal neuralgia relies on biplanar fluoroscopic imaging and surface landmarks. However, anatomical variations and imaging limitations often necessitate multiple attempts, leading to patient discomfort and increased procedural risks. This study evaluated the procedural outcomes of radiofrequency rhizotomy using preplanned trajectories and intraoperative computed tomography with neuronavigation.
designRetrospective study.
settingSingle-center study conducted in a neurosurgical department.
participantsForty-six patients with trigeminal neuralgia who underwent radiofrequency rhizotomy between September 2019 and December 2024 were recruited in this study.
interventionCannulation of the foramen ovale was performed using navigation-guided trajectories, with intraoperative computed tomography used to adjust the trajectory if initial attempts failed. Success rates and the distances between the landmark-based and neuronavigation-guided entry points were measured.
resultsAmong the 46 procedures, the entry points were adjusted from the landmark-based entry points in 22 patients (47.8%) to achieve successful foramen ovale cannulation. Adjustments involved inferolateral displacement in 17 cases and inferomedial displacement in 5 cases. The mean lateral displacement was 3.75 ± 5.40 mm, and the mean inferior displacement was 14.65 ± 6.91 mm. Foramen ovale cannulation was successfully achieved in all the patients without complications.
conclusionsIntraoperative computed tomography and navigation-guided radiofrequency rhizotomy are safe and effective techniques for treating trigeminal neuralgia. The conventional entry point designated by surface landmarks was not optimal in 47.8% cases, who required an inferior shift to accommodate anatomical variations.
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