Impact of age on postoperative pain relief following microvascular decompression for trigeminal neuralgia

To investigate the impact of age on postoperative pain outcomes following microvascular decompression (MVD) for trigeminal neuralgia (TN). We retrospectively analyzed 135 patients with classic TN who underwent MVD at our hospital between January 2020 and December 2024. Patients were divided into two groups for analysis: those older than 60 years (> 60 year group) and those aged 60 years or younger (≤ 60 year group). There were 85 patients aged 60 years or younger and 50 patients older than 60 years. The mean follow-up period was 35 months. When patients were divided into good pain control (BNI I–II) and poor pain control (BNI III–V) groups, 82.3% of the older patient group had good pain control at most recent follow-up, while 56.3% of the younger patient group had good pain control at most recent follow-up ( P = 0.040). Univariate regression analysis revealed that age, preoperative drug responsiveness, and intraoperative arterial compression were significantly associated with good pain control; multivariate regression analysis showed that age and intraoperative arterial compression were significantly correlated with good pain control. For some patients with TN over 60 years, MVD may achieve good pain prognosis.