Combined Conventional and Pulsed ‘CCPRF’ Versus Pulsed ‘PRF’ Radiofrequency Ablation in Patients with Refractory Typical Trigeminal Neuralgia. A Multicentric, Retrospective and Comparative study.

Document Type : Original Articles

Authors

1 Department of Neurosurgery, Suez Canal University.

2 Department of Neurosurgery, Suez Canal University

Abstract

Background: The prevalence of typical TN in Egypt is 29.5/100,000. TN is termed ‘the suicidal disease’. There are 2 modes of lesion in radiofrequency ablation which are conventional (CRF) and pulsed (PRF) radiofrequency ablations. CRF has good results in pain control, however, it has unbearable side effects. PRF acts by modulation in the pain fibers ‘nociceptive fibers’ results in pain relief with little tissue damage thus less side effects. PRF was reported to be ineffective as a monotherapy for TN.
Aim: To assess the PRF versus CCPRF in TN.
Patients and Methods: This is a retrospective comparative study, between March 2017 and January 2020. Selection criteria were typical ‘classic’ trigeminal neuralgia, any age, complete records with follow-up period of 12 months. Clinical evaluation by the BNI scale for pain and the BNI scale for pain and numbness post-operatively, and the trigeminal segment affected, were obtained.
Results: 23 underwent PRF and 20 underwent CCPRF. Facial pain assessment by BNI scale in the immediate follow-up showed a statistically significant improvement in both groups. No significant difference in the BNI scale for facial numbness on both groups with means of 1.39±0.4 and 1.85±0.67 respectively. At 12-month follow-up CCPRF had the better pain control than PRF, and in PRF group with 3 patients with total relapse to the original pain intensity in the PRF group.
Conclusion: CCPRF has proven to obtain long term pain relief over PRF with less bothering side effects.

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