• Sarah K Bick, David Huie, Gabriel Sneh, and Emad N Eskandar.
• Department of Neurosurgery, Mas-sachusetts General Hospital, Boston, Mas-sachusetts.
• Neurosurgery. 2019 Jan 1; 84 (1): 116-122.

BackgroundTrigeminal neuralgia (TN) increases in prevalence with age. Although microvascular decompression (MVD) is the most effective long-term operative treatment for TN, its use in older patient populations has been debated due to its invasive nature. Recent studies have demonstrated safety of MVD in older patients; however, efficacy data are more limited.ObjectiveTo determine the relationship between age and pain outcomes following MVD for TN.MethodsSubjects underwent MVD for TN at our institution between 1/1/2004 and 12/31/2013, had typical TN, and demonstrated neurovascular compression on preoperative imaging. We performed a retrospective case series study by reviewing the electronic medical records and performing phone interviews to determine long-term outcomes. We divided patients into 2 groups for analysis, under 60 and 60 yr of age and older.ResultsOne hundred twenty-four subjects were included in the study, 82 under 60, and 42 60 yr of age and older. The average length of follow-up was 42.4 mo. Patients in the older age group had average pain score of 1.57 at most recent follow-up, while for the younger age group it was 2.18 (P = .0084). Multiple regression analysis found that older age, male gender, and preoperative medication responsiveness were significantly correlated with lower long-term pain scores, while V2 dermatome involvement was correlated with higher long-term pain scores.ConclusionPatients 60 yr of age and older have significantly better long-term pain outcomes following MVD than younger patients.

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