• Eur Spine J · Feb 2025

    Review

    Trigeminal neuralgia as a presentation of high cervical stenosis: a systematic review of the literature.

    • G Barbagli, O Aglan, A Hussein, D Soto-Rubio, N Pacheco-Barrios, C Li, A Al-Arfaj, J Kelbert, N Dholaria, A Pico, C M Deaver, I Alhalal, M Prim, and A A Baaj.
    • Department of Neurosurgery, University of Arizona College of Medicine, 1111 Mc Dowell Road, Phoenix, AZ, 85006, USA. barbagligiovannimd@gmail.com.
    • Eur Spine J. 2025 Feb 1; 34 (2): 707718707-718.

    PurposeAn atypical presentation of cervical spondylopathy (CS), trigeminal neuralgia (TN) is attributable to the extension of trigeminal nuclei into the spinal cord and is frequently overlooked, leading to limited discussion with patients regarding potential anterior cervical surgery. Our systematic review assesses the effectiveness of cervical surgery for concurrent trigeminal neuralgia in cases of cervical spondylopathy.MethodsA systematic review exploring cases of trigeminal neuralgia related to cervical spondylopathy was conducted searching on PubMed, Scopus and Embase databases for article in English. The authors excluded literature reviews and paediatric studies. Abstracts from articles were initially screened, followed by a detailed review of full-text papers. We included studies that documented cases of trigeminal neuralgia unrelated to cranial pathologies in patients with cervical spondylopathy.ResultsFollowing the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol, 6 studies were included covering 30 patients (20 male, 10 female) with a mean age of 60.75 years and average symptom duration was 18 months. The most affected branches were V2 (41%) and V3 (49%), evenly distributed between left and right sides (55% vs 45%). Motor weakness (60%) and paresthesia (27%) were common non-trigeminal symptoms. The predominant compression levels were C2-C3 (38%) and C3-C4 (34%). After anterior cervical surgery (30% of patients), 100% experienced immediate resolution of trigeminal neuralgia, with no recrudescence at an average 7-month follow-up.ConclusionBesides common manifestations, high cervical stenosis can cause trigeminal neuralgia. This case report and systematic review confirms spinal decompression and fusion surgery may be effective in select cases. Surgeons should raise the possibility of cervical spine involvement when counseling patients with this disease.© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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