{'fraction_non_alphanumeric': 0.017911751856705984, 'fraction_numerical': 0.009174311926605505, 'mean_word_length': 5.4145658263305325, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Commentary: Percutaneous Balloon Compression vs Percutaneous Retrogasserian Glycerol Rhizotomy for the Primary Treatment of Trigeminal Neuralgia.

Compression vs Percutaneous Retrogasserian Glycerol Rhizotomy for the Primary Treatment of Trigeminal Neuralgia From 1986 to 2000, the authors performed percutaneous retrogasserian glycerol rhizotomy (PRGR) as the percutaneous treatment of choice for patients with trigeminal neuralgia who were not felt to be good candidates for microvascular decompression. Since 2000, the same patient population has instead been offered a percutaneous balloon compression (PBC) under general anesthesia. Here, the authors retrospectively review their prospectively collected data on the patients treated and compare the 2 cohorts. Interestingly, their results demonstrate that although the duration of pain relief did not differ significantly between the 2 modalities, PBC is suggested to be a superior method because of its fewer side effects and fewer technical failures. Specifically, the authors found dysesthesias after 23% of the PRGR procedures but after only 4% of the PBCs. Decreased corneal sensation was also significantly more common in the PRGR group. Finally, 6% of the PRGR procedures were unable to be properly completed, whereas there were no technical failures in the PBC group. We also favor PBCover PRGR for some of the same reasons that were identified in this study. We find PBC to be more technically straightforward, and the procedure benefits from real-time obvious fluoroscopic feedback (balloon taking a pear shape) and an unconscious, cooperative, and comfortable patient. Additionally, the results here certainly suggest that the broad uniform compression in theMeckel cave as a means to disrupt the ganglion does less inadvertent and unwanted damage than themore focused mechanism of a PRGR procedure, yet the pain relief is comparable, a finding thatMullan and Lichtor put forth.30 years ago. This study provides a helpful and clear contribution to the literature on PBC and PRGR as a first-line treatment for trigeminal neuralgia. The fact that this was first-time treatment for all patients will limit its conclusions for those patients who have undergone at least 1 procedure in the past and come looking for more relief.