Clinical Characteristics and Early Pain Outcomes After Microvascular Decompression for Trigeminal Neuralgia: A Single-Center Retrospective Cohort Study

Background: Trigeminal neuralgia is a chronic neuropathic pain disorder characterized by severe recurrent facial pain and substantial impairment in quality of life. Although microvascular decompression (MVD) is an established surgical treatment for medically refractory cases, routine clinical data integrating clinical characteristics, previous interventional treatment history, and early postoperative outcomes remain limited. This study aimed to describe the clinical profile and early postoperative outcomes of patients undergoing MVD for trigeminal neuralgia in a single-center retrospective cohort. Methods: This single-center, single-surgeon retrospective cohort study included 62 adult patients who underwent MVD at Pamukkale University Hospitals between 4 September 2019 and 9 July 2026. Demographic and clinical characteristics, previous interventional procedures, trigeminal nerve division involvement, vascular compression status, surgical opening approach, postoperative Barrow Neurological Institute (BNI) pain intensity scores, visual analog scale (VAS) pain scores, wound-related complications, and exploratory perioperative inflammatory markers were retrospectively collected. Favorable postoperative outcome was defined as BNI Grade I–II. Results: The mean age was 51.9 ± 12.8 years, 66.1% were female, and vascular compression was identified in 87.1%. A previous interventional procedure was documented in 35.5%. Favorable BNI outcomes occurred in 74.2% (95% CI, 62.1–83.4%), and complete pain relief (VAS = 0) in 88.7% (95% CI, 78.5–94.4%). Wound-related complications occurred in 9.7%. No evaluated baseline characteristic was significantly associated with either pain outcome. Paired analyses showed no significant perioperative change in CRP (p = 0.353), whereas NLR increased significantly (p = 0.001). Conclusions: MVD was associated with favorable early postoperative pain outcomes in most patients. However, the retrospective design, modest sample size, and symptom-driven longer-term follow-up limit conclusions regarding prognostic determinants and durability of pain relief.