Open AccessPredictive Factors Associated with Success and Failure for Radiofrequency Thermocoagulation in Patients with Trigeminal Neuralgia
Author(s) -
Hyun Seung Jin,
Ji Yeon Shin,
Yong Chul Kim,
Sang Chul Lee,
Eun Joo Choi,
Pyung Bok Lee,
Jee Youn Moon
Publication year - 2015
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2015/18/537
Subject(s) - medicine , trigeminal neuralgia , radiofrequency thermocoagulation , odds ratio , multivariate analysis , etiology , neuropathic pain , logistic regression , univariate analysis , prospective cohort study , neuralgia , surgery , anesthesia
Background: Radiofrequency thermocoagulation (RFT) has been widely used to managetrigeminal neuralgia (TN) refractory to oral medication. Careful selection of patients formanaging TN with RFT can decrease morbidity and improve treatment efficacy.Objectives: The goal of this study was to determine clinical variables related to the treatmentoutcome in patients with TN undergoing RFT.Study Design: Retrospective analysis.Setting: University hospital in Korea.Methods: Demographic and clinical data were garnered by billing records for patients withTN who received RFT by one pain physician between January 2005 and August 2014. Asuccessful outcome was pre-defined as at least 50% pain relief on a 0 – 10 NRS pain scorefor longer than 6 months after RFT. Variables evaluated for their association with outcomeincluded age, gender, baseline pain score, etiology, type of pain, co-existing psychopathology,and history of previous intervention.Results: Among 90 patients who underwent RFT for managing TN, 75 patients (83.3%)reported a successful outcome (> 50% pain relief at 6 months after RFT procedure). Paincharacteristics was the most significant predictor associated with successful outcomes of RFTin both univariate and multivariate logistic analysis; odds ratio of provoked paroxysmal painwas 131.516 and mixed type of pain was 20.602 in multivariate analysis.Limitations: Prospective studies are recommended to confirm our findings and ascertainwhich additional variables can be taken into account to improve the likelihood of a successfuloutcome for RFT in patients with TN.Conclusion: A provoked paroxysmal pain or mixed pain condition was associated with apositive outcome for RFT in patients with TN. In addition, bilateral TN, high baseline NRS painscore, or co-morbid psychiatric condition was related with negative outcomes in univariateanalysis. Pain clinicians should consider these findings when selecting patients for managingTN to increase the efficacy of RFT.Key words: Facial pain, outcome assessment, predictive value, radiofrequencythermocoagulation, trigeminal neuralgia