Evidence map›Paper›PMID 40833460›Full record

SynthesisNeurosurgical review2025

Comparison of stereotactic radiosurgery and rhizotomy for trigeminal neuralgia: A systematic review and Meta-Analysis.

Alireza Soltani Khaboushan, Seyed Farzad Maroufi, Negin Jarrah, Maral Moafi, Mohammadmahdi Sabahi, Hamid Borghei-Razavi, Jason P Sheehan

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alireza Soltani KhaboushanDepartment of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran.
Seyed Farzad MaroufiDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Negin JarrahSchool of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Maral MoafiCell Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohammadmahdi SabahiDepartment of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA.
Hamid Borghei-RazaviDepartment of Neurological Surgery, Pauline Braathen Neurological Center, Cleveland Clinic Florida, Weston, FL, USA.
Jason P SheehanDepartment of Neurological Surgery, University of Virginia, Charlottesville, VA, USA. jps2f@virginia.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTrigeminal neuralgia (TN) is a chronic, debilitating neuropathy characterized by sudden, severe facial pain, often refractory to medical therapy. When medications fail, surgical options such as microvascular decompression (MVD) are preferred, but for patients unsuitable for open surgery, stereotactic radiosurgery (SRS) and percutaneous rhizotomy are viable alternatives. This systematic review and meta-analysis aimed to compare the efficacy and safety of SRS and rhizotomy in the management of TN.

methodsFollowing PRISMA guidelines, PubMed, Embase, Scopus, and Web of Science were searched up to September 2024 for studies comparing SRS and rhizotomy in TN patients. Eligible studies reported pain relief, recurrence, retreatment rates, or complications. Data were extracted and analyzed using a random-effects model, with subgroup analyses for multiple sclerosis (MS) status.

resultsFifteen studies involving 1,251 patients (577 SRS, 674 rhizotomy) were included. Rhizotomy provided superior initial pain-free outcomes (RR = 0.66, 95%CI = 0.49 ;0.91, p < 0.01), while SRS showed no significant difference in pain-free rates at the last follow-up (RR = 0.99, 95%CI = 0.80 ;1.22, p = 0.89) or overall pain relief (RR = 1.14, 95%CI = 0.90 ;1.44, p = 0.29). SRS significantly reduced recurrence (RR = 0.70, 95%CI = 0.51 ;0.96, p < 0.05), retreatment need (RR = 0.67, 95%CI = 0.46 ;0.96, p < 0.05), and facial numbness (RR = 0.61, 95%CI = 0.37 ;0.99, p < 0.05). Overall complications were comparable (RR = 0.70, 95%CI = 0.34 ;1.43, p = 0.33), though SRS trended toward fewer complications in MS patients.

conclusionRhizotomy provides immediate pain relief, making it suitable for patients requiring rapid results, while SRS offers greater durability and lower morbidity. Treatment choices should be tailored to patient-specific factors, including the urgency of relief and MS status. Future prospective studies with standardized outcomes and extended follow-up are needed to address the limitations of retrospective data and study heterogeneity.

Indexed as

RadiosurgeryRhizotomyTrigeminal NeuralgiaHumansTreatment OutcomeBalloon compressionGlycerol rhizotomyRadiofrequency thermoablationRhizotomyStereotactic radio surgeryTrigeminal neuralgia

Identifiers

PMID40833460
PMCPMC12368101

What Socratic holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.