Radiosurgical management of trigeminal neuralgia; Differences in outcomes between proximal and distal targeting: Meta-analysis of 1055 patients.
Neurosurg RevSep 19, 2026 (epub)
Juan Pablo Martinez, Jose Alfonso Alvarez-Castro, Maria Lizeth Nieves-Pimienta et al.
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In 30 seconds
This meta-analysis evaluated the outcomes of stereotactic radiosurgery (SRS) for trigeminal neuralgia (TN) in 1055 patients, comparing proximal and distal targeting. The study found that distal targeting resulted in significantly greater pain relief at 30 days (RR = 1.37, 95%CI: 1.14-1.65; P = 0.001), while no significant differences were observed at 90 days or in long-term outcomes.
Key findings
- Pain relief at 30 days was significantly higher with distal targeting (RR = 1.37, P = 0.001).
- No significant difference in pain relief at 90 days between proximal and distal targets (RR = 1.11, P = 0.30).
- Rates of facial numbness were similar for both targeting methods (RR = 1.10, P = 0.75).
- Medication de-escalation rates did not differ significantly between targets (RR = 1.29).
Why it matters
Understanding the differences in outcomes between proximal and distal targeting in SRS for TN can guide clinicians in selecting the most effective approach for rapid pain relief, which is crucial for patient quality of life.