3 三叉神経痛に対する治療戦略(第616回新潟医学会,ペインクリニックの現状と問題点)

概要

論文の詳細を見る
We retrospectively studied on treatment effects of microvascular decompression (MVD) and Gamma knife surgery (GKS) for trigeminal neuralgia. Sixty seven patients underwent MVD and followed up for a median 64.5 months (range 9-188 months). The mean age was 59.8 years (range 33-83 years). Thirty-three patients underwent GKS and followed up for median 23.9 months (range 7-58 months). The mean age was 73.1 years (range 46-87 years). Patient outcomes were excellent in 48 of 67 patients (71.6%) after MVD and 10 of 33 patients (30.3%) after GKS, respectively. Overall, 91.0% of patients were free from pain after MVD, whereas 48.5% were free from pain after GKS. We believe that MVD should remain the primary operation for patients with trigeminal neuralgia if they are medically fit. Gamma knife surgery may provide benefit to elderly patients who can not undergo MVD under general anesthesia.