A Comparative Review of the Outcome following MVD and PBC in Patients with Trigeminal Neuralgia

Objective This study is aimed to systematically review the treatment outcomes between percutaneous balloon compression (PBC) and microvascular decompression (MVD) in patients with trigeminal neuralgia. 
Methods A systematic review in accordance with the PRISMA guideline was performed using PubMed, Embase and Cochrane CENTRAL databases. Only those articles with more than 5 years’ follow-up length were included in this investigation. In order to uniformly assess the postoperative outcome, we defined pain relief for those totally pain free, while the postoperative hospitalization and last follow-up period as early and long-term, respectively. The facial numbness was quantified with BNI score. 
Results After database searching and screening, 7797 cases were enrolled finally according the criteria. The early pain relief rates were 94.1% (1551/1649) and 89.9% (4962/5482) following PBC and MVD (OR=0.603, p<0.05), while the long-term 58.1% (921/1566) and 74.9% (4549/6074) (OR=2.089, p<0.05), respectively. Although a significant higher facial numbness occurred in PBC group in the early stage, it was mostly diminished 5 years later compared with MVD group. At long-term follow-up, hypoacousia and facial palsy occurred more often in MVD group (p<0.05).
Conclusions Both MVD and PBC provide a satisfactory outcome for the patients in long-term. As a simple, safe and reliable technique, PBC should not be shrugged off by neurosurgeons.