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TN-RS: a novel scoring system predicts Gamma Knife Radiosurgery outcome for trigeminal neuralgia patients.
Orlev, Alon; Feghali, James; Kimchi, Gil; Sun, Lian; Pierre, Clifford; Gragnaniello, Cristian; Cotrutz, Cristian; Loiselle, Christopher; Vermeulen, Sandra; Litvack, Zachary.
Afiliación
  • Orlev A; Swedish Neuroscience Institute, Seattle, WA, USA. dr.aorlev@gmail.com.
  • Feghali J; Department of Neurosurgery, Rabin Medical Center, Affiliated to Sackler Medical School, 39 Jabotynski St., 49414, Petach Tikva, Israel. dr.aorlev@gmail.com.
  • Kimchi G; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
  • Sun L; Department of Neurosurgery, Sheba Medical Center, Ramat-Gan, Affiliated to Sackler Medical School, Tel-Aviv University, Tel-Aviv, Israel.
  • Pierre C; Department of Biology, University of Washington, Bothell, WA, USA.
  • Gragnaniello C; Swedish Neuroscience Institute, Seattle, WA, USA.
  • Cotrutz C; Swedish Neuroscience Institute, Seattle, WA, USA.
  • Loiselle C; Department of Neurosurgery, Long School of Medicine, University of Texas, San Antonio, TX, USA.
  • Vermeulen S; Swedish Radiosurgery Center, Seattle, WA, USA.
  • Litvack Z; Swedish Radiosurgery Center, Seattle, WA, USA.
Acta Neurochir (Wien) ; 165(12): 3895-3903, 2023 Dec.
Article en En | MEDLINE | ID: mdl-37922000
BACKGROUND: Gamma Knife Radiosurgery (GKRS) is an effective treatment option for medically refractory trigeminal neuralgia (TN). This study examines GKRS outcome in a large cohort of TN patients and highlights pretreatment factors associated with pain relief. METHODS: This is a single-center retrospective analysis of patients treated with GKRS for TN between 2011 and 2019. Pain relief was assessed at 1 year, and 2-3 years following GKRS. Multivariable analysis identified several factors that predicted pain relief. These predicting factors were applied to establish a pain relief scoring system. RESULTS: A total of 162 patients met inclusion criteria. At 1 year post-GKRS, the breakdown of Barrow Neurological Institute (BNI) score for pain relief was as follows: 77 (48%) score of I, 13 (8%) score of II, 37 (23%) score of III, 22 (14%) score of IV, and 13 (8%) score of V. Factors that were significantly associated with pain-free outcome at 1 year were: Typical form of TN (OR = 2.2 [1.1, 4.9], p = 0.049), No previous microvascular decompression (OR = 4.4 [1.6, 12.5], p = 0.005), Response to medical therapy (OR = 2.7 [1.1, 6.1], p = 0.018), and Seniority > 60 years (OR = 2.8 [1.4, 5.5], p = 0.003). The term "Trigeminal Neuralgia-RadioSurgery" was used to create the TN-RS acronym representing the significant factors. A stepwise increase in the median predicted probability of pain-free outcome at 1 year from 3% for patients with a score of 0 to 69% for patients with a maximum score of 4. CONCLUSION: The TN-RS scoring system can assist clinicians in identifying patients that may benefit from GNRS for TN by predicting 1-year pain-free outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuralgia del Trigémino / Radiocirugia Límite: Humans Idioma: En Revista: Acta Neurochir (Wien) Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Austria
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuralgia del Trigémino / Radiocirugia Límite: Humans Idioma: En Revista: Acta Neurochir (Wien) Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Austria