The Clinical Value of Preoperative MRI Measurement of Meckel's Cave Volume in Percutaneous Balloon Compression Surgery for Trigeminal Neuralgia

Objective To explore the clinical value of magnetic resonance imaging (MRI)-measured Meckel's cave volume in percutaneous balloon compression (PBC) for the treatment of trigeminal neuralgia (TN). Methods A total of 51 patients with primary TN receiving PBC from May 2021 to May 2024 were retrospectively enrolled. Preoperative MRI was used to measure Meckel's cave volume. Patients' clinical data, pain severity, mental status, and quality of life before and after treatment were analyzed. Results All 51 patients successfully underwent the surgery, with a success rate of 100% and an overall effective rate of 98.04%. The postoperative pain score was significantly lower than that before the operation ( P <0.05), and the quality of life was significantly improved ( P <0.05). The average follow-up time was 19.20 ± 7.68 months. The overall recurrence rate was 17.65% (9/51), with recurrence rates of 1.96% (1/51) at 6 months, 3.92% (2/51) at 12 months, and 11.76% (6/51) at 24 months. For all patients and non-recurrent patients, the compression coefficient (balloon volume/Meckel’s cave volume) was 1.079–1.790 and 1.401–1.709, respectively. The compression coefficient was an independent risk factor for recurrence ( P <0.001), and the smaller the compression coefficient, the higher the risk of recurrence. Conclusion MRI measurement of Meckel's cave volume is valuable for guiding individualized balloon inflation during PBC surgery. A compression coefficient of 1.401–1.790 may represent the optimal range for favorable PBC outcomes. Further prospective studies are warranted.