Does egress of cerebrospinal fluid during percutaneous retrogasserian glycerol rhizotomy influence long term pain relief?
GROUND AND OBJECTIVES: To examine the effect of cerebrospinal fluid (CSF) flow during percutaneous retrogasserian glycerol rhizotomy (PRGR) on long term pain relief in patients with trigeminal neuralgia. METHODS: Eighty-nine patients with trigeminal neuralgia underwent 102 PRGR procedures. PRGR was conducted under fluoroscopy. After the egress of CSF, anhydrous glycerol (0.3-0.4 cc) was injected in the sitting position. In the absence of CSF flow, 0.25 mL 2% lidocaine was injected to elicit hypesthesia in the affected side. Once hypesthesia was elicited glycerol was injected. Patients were grouped as A (CSF flow present) or B (CSF flow absent), according to the egress of CSF at the time of needle placement. Patients were followed up for the recurrence of pain (average duration of follow up, 62 months). RESULTS: CSF flow was present in 54 patients (60.6%) and absent in 35 patients (39.4%). Thirty patients (56.6%) of group A had excellent pain relief, 18 patients (33.3%) had good pain re
