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Efficacy and safety of radiofrequency in the treatment of trigeminal neuralgia: a systematic review and meta-analysis

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Abstract

To assess the effectiveness of radiofrequency (RF) versus other percutaneous strategies (balloon compression, glycerol rhizotomy [GR], and microvascular decompression [MVD]) in patients with trigeminal neuralgia. We systematically searched the electronic databases of PubMed, Embase, and the Cochrane Library to identify eligible studies throughout October 2020. The odds ratio (OR) with 95% confidence interval (CI) was applied to assess effect estimates using the random-effects model. Eighteen retrospective cohort studies that enrolled 6391 patients with trigeminal neuralgia were included. We noted that RF was associated with an increased incidence of immediate pain relief compared with GR (OR 2.65; 95% CI 1.29–5.44; P = 0.008). Moreover, RF was associated with an increased risk of pain recurrence compared with MVD (OR 3.80; 95% CI 2.00–7.20; P < 0.001). Furthermore, RF was associated with an increased incidence of postoperative anesthesia compared with GR (OR 3.01; 95% CI 1.11–8.13; P = 0.030) or MVD (OR 4.62; 95% CI 2.15–9.93; P < 0.001). This study found that RF was superior to GR for the improvement in immediate pain relief; whereas, RF yielded an excess risk of pain recurrence compared with MVD. Moreover, the incidence of postoperative anesthesia in patients treated with RF significantly increased compared with the incidence after treatment with GR and MVD.

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Author notes

  1. Congyang Yan, Qianxi Zhang and Cheng Liu are co-first authors and contributed equally to this article.

Authors and Affiliations

  1. Department of Neurology, Lianshui People’s Hospital, Huai’an, China

    Congyang Yan

  2. Department of Radiology, The Affiliated Huai’an Hospital of Xuzhou Medical University, Huai’an, China

    Qianxi Zhang

  3. Department of Pain and Interventional Radiology, Huai’an Hospital of Huai’an City, No. 161, Zhenhuailou East Road, Huai’an, China

    Cheng Liu, Jiali Yang, Hu Bian & Tongqing Xue

  4. Department of Interventional Radiology, The Third People’s Hospital of Yancheng, Yancheng, China

    Jun Zhu

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Contributions

CY, QZ and CL designed the work. QZ, JY and CL acquired the date. JY, JZ and HB analyzed the data. TX and HB were a major contributor in writing the manuscript. TX revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Tongqing Xue.

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Yan, C., Zhang, Q., Liu, C. et al. Efficacy and safety of radiofrequency in the treatment of trigeminal neuralgia: a systematic review and meta-analysis. Acta Neurol Belg 122, 1019–1030 (2022). https://doi.org/10.1007/s13760-021-01654-w

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