neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2016-0-4-49-56neurosurgery-373Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTПРИМЕНЕНИЕ МИКРОВАСКУЛЯРНОЙ ДЕКОМПРЕССИИ КОРЕШКА ТРОЙНИЧНОГО НЕРВА У ПАЦИЕНТОВ СТАРЧЕСКОЙ ВОЗРАСТНОЙ ГРУППЫ С ТРИГЕМИНАЛЬНОЙ НЕВРАЛГИЕЙThe usage of microvascular decompression of root of trigeminal nerve in elderly patients suffered from trigeminal neuralgiaРзаевДжамиль АфетовичRzaevD. A.d_rzaev@neuronsk.ru; d_rzaev@neuronsk.ruМойсакГалина ИвановнаMoisakG. I.g_moysak@neuronsk.ru; g_moysak@neuronsk.ruАмелинаЕвгения ВалерьевнаAmelinaE. V.amelina.evgenia@gmail.comКуликоваЕлена ВикторовнаKulikovaE. V.e_kulikova@neuronsk.ruФГБУ Федеральный центр нейрохирургииRussian FederationФГБУ Федеральный центр нейрохирургии; Новосибирский государственный университетRussian FederationФГБУН Конструкторско-технологический институт вычислительной техники СО РАНRussian Federation201624112017044956Copyright © Рзаев Д.А., Мойсак Г.И., Амелина Е.В., Куликова Е.В., 20172017Рзаев Д.А., Мойсак Г.И., Амелина Е.В., Куликова Е.В.Rzaev D.A., Moisak G.I., Amelina E.V., Kulikova E.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/373

Цель: оценка эффективности и безопасности применения микроваскулярной декомпрессии корешка тройничного нерва у пациентов с ТН старческой возрастной группы. Материалы и методы: С ноября 2012 г. по август 2015 г. прооперировано 17 больных (13 женщин и 4 мужчин) старше 75 лет с ТН. Для оценки выраженности болевого синдрома использовали визуальную аналоговую шкалу, шкалу боли Неврологического института Barrow, BPI-Facial. Оценку результатов оперативного вмешательства проводили с помощью шкалы исходов операций Miller (2009) и шкалы Kondo A. Ии соавт. (2012). В ходе исследования изучали показатели эффективности и безопасности вмешательства между двумя основными возрастными группами (до 75 лет и 75 лет и старше). Результаты: Анализ системных, неврологических и других видов осложнений в раннем послеоперационном периоде, а также эффективности вмешательства не выявил значимой разницы между возрастными группами. При изучении катамнеза в старшей возрастной группе рецидивы ТН после операции составили 17,6%, что было сравнимо с показателями в других группах (18,4%). Заключение: Микроваскулярная декомпрессия корешка тройничного нерва ТН может с успехом быть применена для лечения больных старческой возрастной группы при условии тщательного отбора пациентов и точного предоперационного планирования.

Introduction: Microvascular decompression (MVD) is the method of choice for treatment of trigeminal neuralgia (TN) in cases of revealed neurovascular conflict. It is traditionally considered that this surgical technique is contraindicated for elderly patients. These patients are often offered the various destructive methods. Objective: To evaluate the efficacy and safety of MVD of the trigeminal nerve root in patients with TN older than 75 years (elderly patients). Materials and Methods: authors performed MVD in 17 elderly patients (13 women, 4 men) suffered from TN from 2012 to 2015. VAS, BNI Pain Scale and BPI-Facial were used before and after MVD to estimate the pain intensity. The surgery results were assessed using scales by Miller (2009) and by Kondo A. et al. (2012). The efficacy and the safety of surgical intervention were evaluated between the two main groups (up to 74 years and older than 75 years). Results: The conducted analysis did not reveal any statistically significant differences between the patients of two groups as well as while analyzing the efficacy and safety of MVD. The relapse of pain after MVD within follow-up period was comparable in two groups (in 17.6% in elderly patients and 18.4% in younger patients). Conclusion: MVD in patients older than 75 years was found to be a safe and effective surgery given that precise preoperative planning which includes the evaluation of physical status of patients.

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The authors declare that there are no conflicts of interest present.