Microvascular decompression for trigeminal neuralgia: recurrences and complications.

BACKGROUND: The purpose of this study was to review the complications and pain recurrences after microvascular decompression (MVD) for trigeminal neuralgia. METHODS: This is a retrospective review of 156 patients undergoing MVD in the last 25 years at Princess Alexandra Hospital, Brisbane, Australia. Patients were contacted by telephone and a questionnaire was used for the interview. RESULTS: The probability of becoming pain free after MVD in our study was 0.93. There were no deaths and the incidence of serious complication was 2%. Our complication profile is similar to other authors. Pain recurrences occurred in 18% of patients over a 25 year period. This was most likely within two years of surgery and thereafter occurred at a rate of 2-3.5% a year. Seventy-four percent of patients were still pain free at 10 years. In half of the patients the recurrence was not as severe as the initial occurrence of pain. Thirty percent of recurrences occurred on the opposite side. Eighteen percent of patients were not pain free despite any intervention. CONCLUSIONS: Microvascular decompression in experienced hands has an excellent pain outcome in the majority of patients. Major complications are uncommon.