Comparative Study Between Gamma-Knife, Radiofrequency Ablation, and Microvascular Decompression in the Treatment of Trigeminal Neuralgia

Document Type : Original Article

Authors

1 Department of Neurosurgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

2 Department Anesthesia, Faculty of Medicine, Seuz Canal University, Ismailia, Egypt.

Abstract

Background: Trigeminal neuralgia (TN) is a debilitating disorder that presents as severe, episodic facial pain, typically affecting the ophthalmic or maxillary branches of the trigeminal nerve. This study aimed to compare the clinical outcomes of three commonly used treatment modalities for TN: Gamma-Knife radiosurgery (GK), Radiofrequency ablation (RF), and Microvascular Decompression (MVD).

Methods: This study was a single-center, retrospective, comparative study. It included 45 patients diagnosed with trigeminal neuralgia. Patients were randomly allocated into three treatment groups: Gamma-Knife (Group A), Radiofrequency Ablation (Group B), and Microvascular Decompression (Group C), with 15 patients in each group attending at Al-Azhar University Hospital in Damietta. The primary Outcome was the pain relief post-intervention which was measured using the Visual Analog Scale (VAS).

Results: We found a statistically significant reduction in the severity of pain from 7.4 ± 1.2 at the baseline to 1 ± 0.7 at 1 year postoperatively in the total population (P=0.001). After 1 year, the degree of pain was improved in all studied groups which is better in group 2 and 3 than group 1 (P=0.03), however this difference is no significant clinically.

Conclusion: While all three modalities are effective in managing pain and improving quality of life, MVD and RF ablation provide superior long-term outcomes compared to Gamma Knife.

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