Is percutaneous balloon compression better than microvascular decompression to treat trigeminal neuralgia? A systematic review and meta-analysis

Outcome Comparison of Drug-Resistant Trigeminal Neuralgia Surgical Treatments—An Umbrella Review of Meta-Analyses and Systematic Reviews

“…Most of the included studies were observational ones, with few reported RCTs [ 7 , 9 ]. The included studies compared the different techniques as follows: MVD [ 7 , 8 , 10 , 11 , 12 , 13 , 15 , 16 ], GKS [ 7 , 8 , 10 , 12 ], rhizotomy techniques (PBC, RFR, PGI) [ 7 , 9 , 10 , 11 , 13 , 14 ], SRS [ 7 , 9 , 16 ], cryotherapy [ 7 ], and endoscope-assisted MVD [ 10 , 15 ]. The systematic reviews and meta-analyses differed with regard to the number of included studies, from the 43 studies included by Mendelson et al [ 8 ] to the five included by Sharma et al [ 12 ]; thereafter, the number of patients differed widely among the studies.…”

“…Diana et al [ 7 ], in the studies included, reported an APR rate of 85–96.6%, with similar results reported in the studies of Mendelson et al [ 8 ] and Sharma et al (96%) [ 12 ]. A subgroup analyses in patients without multiple sclerosis (MS) reported a statistically significant ( p < 0.05) higher rate of APR in MVD (86.7–97%) when compared with PBC (72–96%) with an OR of 0.54 (CI 95%: 0.34–0.84) [ 13 ].…”

“…In the subgroup without MS, Nascimento et al reported a trend toward better outcome in long-term follow-up (FU; 6–168 months) for MVD (58–91.2%) with respect to PBC (70–85.8%), with an OR of 0.56 (CI 95%: 0.27–1.13). Recurrence rate analyses showed that patients who underwent the MVD procedure had lower recurrence than those who underwent PBC, with an OR of 0.61 (CI 95%: 0.29–1.26) [ 13 ].…”

“…A study included by Diana et al [ 7 ] and two studies included by Lopez et al [ 9 ] showed a similar rate of immediate pain relief (85% [ 24 ] and 78–88% [ 31 , 32 ], respectively), with a decline at three years to a 53–54% pain relief rate [ 7 , 33 ]. As previously mentioned, PGI had a lower odds of immediate pain relief compared to RF [ 13 , 16 ], but not compared to PBC [ 14 ], and a comparable odd of pain recurrence with respect to both RF and PBC [ 11 , 14 ]. The overall pain recurrence rate was 12.4% according to Chen et al [ 10 ] and the overall complication rate was 24.8% according to Lopez et al [ 33 ].…”

“…Of the 10 enrolled studies, three were systematic reviews [ 7 , 8 , 9 ] and seven were meta-analyses [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ], as reported in Table 1 .…”