Preview

Russian journal of neurosurgery

Advanced search

Glycerol rhizotomy in the treatment of trigeminal neuralgia

https://doi.org/10.63769/1683-3295-2025-27-3-69-78

Abstract

Background. Destructive surgical methods for the treatment of drug-resistant trigeminal neuralgia in the Russian clinical recommendations are classified as options, but at the same time they are in demand and often found in clinical practice. One of them is glycerin rhizotomy by S. Hakanson.

Aim. To evaluate the effectiveness of the treatment of trigeminal neuralgia using glycerin rhizotomy by S. Hakanson.

Materials and methods. A retrospective cohort study was carried out: the results of treatment with glycerol rhizotomy were analyzed in 202 patients with trigeminal neuralgia, who were treated at the Irkutsk City Clinical Hospital No. 1 from 2009 to 2022 years. To study the follow-up, the telephone interview was carried out with 107 patients. Based on the analysis of the literature, the data were compared with the results of the treatment of other surgical methods.

Results. Initial pain relief after surgery was noted in 95 % of patients. Recurrence of pain syndrome (III-V class on the Barrow Neurological Institute Pain Scale) was observed in 32.7 % of patients, while the medium pain intensity on the visual analogue scale score was 7.3 ± 0.26. Pain-free period was 27.7 ± 3.6 of months. There were no deaths.

Conclusion. Glycerin rhizotomy provides immediate pain relief in patients with drug-resistant trigeminal neuralgia. This procedure is effective, minimally invasive, safe, simple and painless for patients in compliance with the algorithm.

About the Authors

A. N. Zhurkin
Irkutsk Scientific Center of Surgery and Traumatology
Russian Federation

Artem N. Zhurkin.

1 Bortsov Revolutsii St., Irkutsk 664003



A. V. Semenov
Irkutsk Scientific Center of Surgery and Traumatology; Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation

1 Bortsov Revolutsii St., Irkutsk 664003; 100 Yubileyniy distr., Irkutsk 664049



S. V. Ochkal
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation

100 Yubileyniy distr., Irkutsk 664049



E. P. Samoylov
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation

100 Yubileyniy distr., Irkutsk 664049



S. A. Sevryuk
Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation

100 Yubileyniy distr., Irkutsk 664049



N. V. Bartul
Irkutsk City Clinical Hospital No. 3
Russian Federation

31 Timiryazeva, Irkutsk 664011



V. A. Sorokovikov
Irkutsk Scientific Center of Surgery and Traumatology; Irkutsk State Medical Academy of Postgraduate Education - Branch Campus of the Russian Medical Academy of Continuing Professional Education
Russian Federation

1 Bortsov Revolutsii St., Irkutsk 664003; 100 Yubileyniy distr., Irkutsk 664049



References

1. Koopman J.S., Dieleman J.P., Huygen F.J. et al. Incidence of facial pain in the general population. Pain 2009;147(1):122–7. DOI: 10.1016/j.pain.2009.08.023

2. Rehman A., Abbas I., Khan S.A. et al. Spectrum of trigeminal neuralgia. J Ayub Med Coll Abbottabad 2013;25(1–2):168–71.

3. Handbook of trigeminal neuralgia. Ed. by G.P. Rath. 1st edn. Singapure: Springer, 2019. 247 p. DOI: 10.1007/978-981-13-2333-1

4. Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edn. Cephalalgia 2018;38:1–211. DOI: 10.1177/0333102417738202

5. Cruccu G., Finnerup N.B., Jensen T.S. et al. Trigeminal neuralgia. J Neurology 2016;87(2):220–8. DOI: 10.1212/wnl.000000000002840

6. Linderoth B. et al. Retrogasserion glycerol rhizolysis in trigeminal neuralgia. In: Quiñones-Hinojosa A. Schmidek and sweet operative neurosurgical techniques: indications, methods, and results, 6th edn. Vol. 2. China: Esevier Saunders, 2012. 1393 p.

7. Håkanson S. Trigeminal neuralgia treated by the injection of glycerol into the trigeminal cistern. Neurosurgery 1981;9(6):638–46.

8. Jaeger R. Permanent relief of tic douloureux by Gasserian injection of hot water. AMA Arch Neurol Psychiatry 1957;77(1):1–7. DOI: 10.1001/archneurpsyc.1957.02330310011001

9. Asplund P., Blomstedt P., Bergenheim A.T. Percutaneous balloon compression vs percutaneous retrogasserian glycerol rhizotomy for the primary treatment of trigeminal neuralgia. Neurosurgery 2016;78(3):421–8; discussion 428. DOI: 10.1227/neu.0000000000001059

10. Chen L., Xu M., Zou Y. et al. Treatment of trigeminal neuralgia with percutaneous glycerol injection into Meckel’s cavity: experience in 4012 patients. Cell Biochem Biophys 2010;58(2):85–9. DOI: 10.1007/s12013-010-9094-z

11. Xu-Hui W., Chun Zh., Guang-Jian Sh. et al. Long-term outcomes of percutaneous retrogasserian glycerol rhizotomy in 3370 patients with trigeminal neuralgia. Turk Neurosurg 2011;21(1):48–52.

12. Blomstedt P.C., Bergenheim A.T. Technical difficulties and perioperative complications of retrogasserian glycerol rhizotomy for trigeminal neuralgia. Stereotact Funct Neurosurg 2002;79(3–4): 168–81. DOI: 10.1159/000070830

13. Pollock B.E. Percutaneous retrogasserian glycerol rhizotomy for patients with idiopathic trigeminal neuralgia: a prospective analysis of factors related to pain relief. J Neurosurg 2005;102(2):223–8. DOI: 10.3171/jns.2005.102.2.0223


Review

For citations:


Zhurkin A.N., Semenov A.V., Ochkal S.V., Samoylov E.P., Sevryuk S.A., Bartul N.V., Sorokovikov V.A. Glycerol rhizotomy in the treatment of trigeminal neuralgia. Russian journal of neurosurgery. 2025;27(3):69-78. (In Russ.) https://doi.org/10.63769/1683-3295-2025-27-3-69-78

Views: 12


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1683-3295 (Print)
ISSN 2587-7569 (Online)
X