Efficacy and safety of microvascular decompression versus percutaneous balloon compression in the treatment of trigeminal neuralgia: a systematic review and meta-analysis

Abstract

Background: Trigeminal neuralgia (TN) is a type of transient and paroxysmal recurrent severe pain confined to the trigeminal nerve region. This study systematically evaluated the efficacy and safety of microvascular decompression (MVD) and percutaneous balloon compression (PBC) in the treatment of TN.

Methods: PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure, Wanfang, and Weipu databases were searched for articles published on the use of MVD and PBC in the treatment of TN from the dates of inception of the databases to October 2019. Articles on MVD and PBC in the treatment of TN were selected, and a meta-analysis was performed using RevMan 5.2 software.

Results: Eighteen studies (comprising 1,932 patients) were included in the study. MVD and PBC had similar overall effective rates in treating TN [odds ratio (OR) =0.79, 95% confidence interval (CI): 0.55-1.13, P=0.19]. Patients treated with PBC had a higher recurrence rate of TN than those treated MVD (OR =3.50, 95% CI: 2.25-5.44; P<0.00001), and patients treated with PBC experienced more adverse reactions than those treated with MVD (OR =17.79, 95% CI: 10.17-31.11; P<0.00001).

Discussion: The overall effective rates of PBC and MVD in the treatment of TN ewer similar, but MVD was associated with better recurrence and a lower rate of adverse reactions. Thus, both MVD and PBC can be used to effectively treat TN patients.

Keywords: Trigeminal neuralgia; meta-analysis; microvascular decompression; overall effective rate; percutaneous balloon compression.