Patient satisfaction and pain relief following radiofrequency rhizotomy for trigeminal neuralgia: a prospective cohort study

Background Trigeminal neuralgia (TN) causes severe facial pain and affects quality of life. Radiofrequency rhizotomy (RFR) is often used when medications fail. This multicenter study assesses pain relief and patient satisfaction following this minimally invasive procedure in affected individuals treated across multiple institutions in Saudi Arabia and Pakistan. Methods In this prospective cohort study, 50 patients aged 40–60 with medically refractory TN (V2/V3) underwent percutaneous RFR at 75°C for 60 s under fluoroscopy, followed by dexamethasone injection. Pain (VAS) and patient satisfaction (PGIC) were evaluated at 1 and 6 months post-procedure. Inter-statistical analysis of patients' clinical outcomes using repeated measures ANOVA and Chi-square tests was performed. Results The average age of the participants was 50.58 ± 5.67 years. 72% were female. The right side was more commonly affected (62%) than the left (38%). The maxillary branch (V2) was the most frequently involved (76%), followed by the mandibular branch (V3) in 24%. Pain scores significantly decreased from a baseline mean of 8.04 ± 0.78–3.20 ± 1.05 at 1 month and 2.58 ± 1.18 at 6 months (p < 0.001). Patient satisfaction scores also improved significantly, from 5.60 ± 1.20 at baseline to 2.52 ± 1.11 at 1 month and 1.92 ± 0.80 at 6 months (p < 0.001). The most common complication was facial numbness (32%), followed by masticator weakness (14%), dysesthesia (6%), hematoma (2%) and pain recurrence occurred in 6% of cases, defined by either an increase in VAS ≥ 4 or the need for a second intervention during the follow-up window. Conclusion Radiofrequency rhizotomy offers effective, well-tolerated pain relief for trigeminal neuralgia with high patient satisfaction. It improves symptom control and outcomes, though further long-term studies are needed to assess sustained benefits and quality-of-life impacts beyond six months.