• Journal of neurosurgery · Apr 2024

    External assessment of preoperative scores for predicting outcome after microvascular decompression for trigeminal neuralgia.

    • Michael E Xie, Kyra Halbert-Elliott, Sumil K Nair, Jinwoo Jun, Bryan C Dong, Kathleen R Ran, Collin B Kilgore, Anita Kalluri, Vivek S Yedavalli, Christopher M Jackson, Michael Lim, Judy Huang, Chetan Bettegowda, and Risheng Xu.
    • 1Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
    • J. Neurosurg. 2024 Apr 26: 171-7.

    ObjectiveRecently, two scoring systems have been developed for predicting pain-free outcomes after microvascular decompression (MVD). Evaluation of these scores on large external datasets has been limited. In this study, the authors aimed to evaluate the performance of published MVD scoring systems in predicting pain-free outcome.MethodsA total of 458 patients who underwent MVD for trigeminal neuralgia (TN) between 2007 and 2020 and had at least 6 months of follow-up were included in this study. Hardaway and Panczykowski scores were retrospectively computed for each patient and compared with postoperative pain recurrence and pain-free duration.ResultsThe mean ± SD area under the receiver operating characteristic curve for predicting any pain recurrence after MVD was 0.567 ± 0.081 using the Hardaway score and 0.546 ± 0.085 using the Panczykowski score. On log-rank tests and Kaplan-Meier analysis, the patients with Hardaway scores of 0-2 had significantly shorter pain-free survival times after MVD than did those with a score of 3. Patients with a Panczykowski score of 1 had a significantly shorter pain-free duration after surgery compared with both patients with scores of 2-3 and patients with scores of 4-5. Patients with Panczykowski scores of 2-3 also had significantly shorter pain-free duration compared with patients with scores of 4-5.ConclusionsBoth the Hardaway and Panczykowski scores may be useful for predicting postoperative pain-free duration in TN patients, and their utility may be greatest when scores are clustered. Continued refinement of both scoring systems will help to improve our ability to predict patient outcomes after MVD.

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