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Microvascular Decompression Versus Stereotactic Radiosurgery for Trigeminal Neuralgia: A Decision Analysis.
Berger, Ian; Nayak, Nikhil; Schuster, James; Lee, John; Stein, Sherman; Malhotra, Neil R.
Afiliação
  • Berger I; School of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.
  • Nayak N; Neurological Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA.
  • Schuster J; Neurological Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA.
  • Lee J; Neurological Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA.
  • Stein S; Neurological Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA.
  • Malhotra NR; Neurological Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA.
Cureus ; 9(1): e1000, 2017 Jan 26.
Article em En | MEDLINE | ID: mdl-28280653
INTRODUCTION:  Both microvascular decompression (MVD) and stereotactic radiosurgery (SRS) have been demonstrated to be effective in treating medically refractory trigeminal neuralgia. However, there is controversy over which one offers more durable pain relief and the patient selection for each treatment. We used a decision analysis model to calculate the health-related quality of life (QOL) for each treatment. METHODS:  We searched PubMed and the Cochrane Database of Systematic Reviews for relevant articles on MVD or SRS for trigeminal neuralgia published between 2000 and 2015. Using data from these studies, we modeled pain relief and complication outcomes and assigned QOL values. A sensitivity analysis using a Monte Carlo simulation determined which procedure led to the greatest QOL. RESULTS: MVD produced a significantly higher QOL than SRS at a seven-year follow-up. Additionally, MVD patients had a significantly higher rate of complete pain relief and a significantly lower rate of complications and recurrence. CONCLUSIONS: With a decision-analytic model, we calculated that MVD provides more favorable outcomes than SRS for the treatment of trigeminal neuralgia.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Idioma: En Revista: Cureus Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Health_economic_evaluation / Prognostic_studies Aspecto: Patient_preference Idioma: En Revista: Cureus Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos