Nomogram prediction model for pain recurrence in patients with trigeminal neuralgia after microvascular decompression

Neurosurg Rev. 2026 Jun 19;49(1):453. doi: 10.1007/s10143-026-04368-w.

ABSTRACT

Microvascular decompression (MVD) is the first-line surgical treatment for trigeminal neuralgia (TN). However, some patients experience recurrence despite achieving immediate pain relief after MVD. This study aimed to identify the risk factors for TN recurrence and to develop a predictive nomogram model. We enrolled patients with TN who achieved immediate pain relief after MVD with at least 2 years of follow-up. Logistic regression analysis was used to explore the risk factors of long-term pain recurrence, based on the results of multivariate logistic regression analysis, a nomogram model for predicting pain recurrence was developed. Receiver operating characteristic curve (ROC) was used to analyze the prediction efficiency of the nomogram model, and calibration curve was used to analyze the accuracy of the nomogram model. Eventually, 264 patients were included in this study, during a mean follow-up of 43.06 ± 16.99 months, 23 patients experienced pain recurrence. Regression analysis suggested that younger age, longer pain duration, and atypical pain were the independent risk factors for long-term pain recurrence. The nomogram demonstrated excellent discriminatory power, with an area under the curve (AUC) of 0.958. The calibration curve analysis indicated good agreement between the predicted and observed probabilities. Favorable long-term outcomes could be achieved in TN patients with immediate pain relief after MVD, patients with younger age, longer pain duration and atypical pain may be at higher risk for pain recurrence.

PMID:42319472 | DOI:10.1007/s10143-026-04368-w