Extended vs. Traditional Operating Table in C-Arm-Guided Percutaneous Balloon Compression of the Gasserian Ganglion for Trigeminal Neuralgia: A Prospective Study.

Abstract

Background: The degree of cervical extension required during percutaneous balloon compression (PBC) of the Gasserian ganglion for trigeminal neuralgia (TN) varies among patients, but the traditional operating tables often fail to fulfil each patient's individual requirements.

Objective: This study aimed to compare the clinical efficacy of an extended operating table to that of a traditional operating table in C-arm-guided PBC of the Gasserian ganglion for TN.

Study design: This is a consecutively prospective comparative study.

Setting: Fujian Provincial Hospital.

Methods: This study consecutively enrolled patients with TN who were scheduled for PBC of the Gasserian ganglion between February 2020 and February 2023. Some patients who underwent the procedure were placed on an extended operating table, whereas others were placed on a traditional operating table. The primary outcome was the duration of the cervical extension. The secondary outcomes included the duration of patient positioning, operation duration, C-arm radiation exposure, and pressure pain threshold of the bilateral trapezius, levator scapulae, and upper trapezius muscles, as well as the occurrence rate of postoperative complications.

Results: A total of 76 patients (mean age of 53.18 ± 2.74 years old, 44 men) were enrolled, with 38 patients using the extended operating table. The baseline characteristics between the extended and traditional operating table groups were comparable (P > 0.05). The duration of the cervical extension was significantly shorter in patients who used an extended operating table than in those who used a traditional operating table (58.77 ± 2.11 vs. 76.49 ± 2.16, P < 0.001). Patients who used an extended operating table exhibited significantly shorter positioning time (3.40 ± 0.45 vs. 10.32 ± 0.66, P < 0.001), operation duration (50.88 ± 2.95 vs. 76.49 ± 2.16, P = 0.020), and C-arm radiation exposure (8.71 ± 1.06 vs. 10.87 ± 1.26, P < 0.001) and significantly higher postoperative 24-hour pressure pain thresholds of the bilateral trapezius muscle (left: 274.39 ± 10.42 vs. 187.05 ± 6.19, P < 0.001; right: 272.89 ± 11.62 vs. 185.42 ± 6.88, P < 0.001), bilateral levator scapulae (left: 357.71 ± 11.37 vs. 245.34 ± 12.87, P < 0.001; right: 353.71 ± 14.14 vs. 245.05 ± 13.20, P < 0.001), and bilateral upper trapezius (left: 253.63 ± 10.91 vs. 163.95 ± 8.44, P < 0.001; right: 255.66 ± 11.99 vs. 165.32 ± 7.93, P < 0.001) compared to those who used a traditional operating table. The occurrence of postoperative adverse events, such as headache, neck pain, back pain, and limb numbness, was significantly lower in the extended operating table group (2.63% vs. 13.79%, P = 0.047) than in the traditional operating table group.

Limitations: This is a single-center study with a small, homogeneous sample, limiting the generalizability of findings; the absence of randomization raises concerns about potential bias; long-term follow-up and recurrence rate measurements were lacking.

Conclusion: This study found that the extended operating table may be an alternative equipment option for C-arm-guided PBC of the Gasserian ganglion for TN.