Neuronavigator-guided percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia

Background Although radiofrequency thermocoagulation is considered as a primary treatment for most patients with trigeminal neuralgia, neuronavigator-guided percutaneous radiofrequency thermocoagulation has been rarely reported. The object of this study was to assess the clinical value of neuronavigator-guided percutaneous radiofrequency thermocoagulation in the treatment of trigeminal neuralgia. Methods The radiofrequency thermocoagulation was performed in 100 cases of trigeminal neuralgia. The patients were positioned supine or sitting, under Hartel's technique (reported by Sweet and Wepsic J Neurosurg 40: 143-156, 1974), by anterior lateral facial approaches. The Gasserian ganglions were acupunctured, assisted by intraoperative CT scanning (3-digital reconstruction) and electrophysiology in order to accurately locate target. Results The needles located in oval foramen at the first puncture, the direction and position could be defined according to the electrophysiology examination. The pain alleviated immediately after operation. There occurred no serious complication and other nerve injury in all patients despite face numbness only. Conclusions 3D-CT and electrophysiology Gasser's ganglion locations can raise the success rate of puncture, enhance the safety and reduce the incidence of complication, showing high academic value and its promising future.