Treatment of primary trigeminal neuralgia with radiofrequency thermocoagulation: report of 648 consecutive cases

PURPOSE: To analyze the clinical efficacy of radiofrequency thermocoagulation in the treatment of idiopathic trigeminal neuralgia,and discuss the method,skill of radiofrequency thermocoagulation and complications.METHODS: 648 patients with idiopathic trigeminal neuralgia,who were treated by radiofrequency thermocoagulation via foramen infraorbitale approach,lateral approach,anterior approach and other approach from July 2001 to March 2011 in our hospital,were observed and the clinical efficacy was evaluated.RESULTS: After the first treatment of the 648 patients,the rate of pain control was 98.3% via foramen infraorbitale approach,91.0% via lateral approach and 95.5% via former approach.The overall response rate was 96.0%.395 patients were followed up from 6 months to 2 years.The recurrent rate within one year was 9.6%,20.5% within two years.Good response was achieved after re-treatment with radiofrequency thermocoagulation in recurrent patients.CONCLUSIONS: The clinical efficacy of radiofrequency thermocoagulation in the treatment of idiopathic trigeminal neuralgia is good and reliable.The operation is simple,the indication is wide,and the complication is fewer.CT location can improve the accuracy of puncture,and reduce complications.