Surgical Treatment of Trigeminal Neuralgia: Partial Sensory Rhizotomy

The pain with the slightest movement during daily life in patients with trigeminal neruralgia (TN) is starting innocuous stimulation such as mastication, washing, and sudden contact with cold air in the face [1]. The pain nature, types according to the etiology, and treatment methods were mentioned in previous chapters [2]. In patients with medical intractability, common surgical techniques including radiofrequency ablation (RFA), stereotactic radiosurgery (SRS), percutaneous balloon compression (PBC), microvascular decompression (MVD), and partial sensory rhizotomy may be done according to its etiology. MVD is the most effective surgical method for treating patients with typical TN (caused by vascular compression of the trigeminal nerve root), with a recurrence rate between 6% and 47% [3-8]. For patients with idiopathic TN (no clear cause) and secondary TN (secondary to other neurological diseases, such as multiple sclerosis) [9, 10], PSR of a quite destructive operation has rarely been done in spite of its complications which is unable to control. The existing literature reported a recurrence rate between 30% and 50% after the first simple PSR [11-15]. Nevertheless, for patients that simple MVD is not applicable, PSR is often required in clinical practice [1].