Abstract
BACKGROUND: The objective of this study was to establish a scoring system for predicting the risk of delayed pain disappearance (DD) after percutaneous balloon compression (PBC) for trigeminal neuralgia. METHODS: A retrospective analysis was conducted on 282 patients with trigeminal neuralgia who underwent PBC, with 217 in the modeling cohort and 65 in the validation cohort. Patients in the modeling cohort were grouped according DD status (DD and non-DD groups). Logistic regression analysis was used to identify risk factors for DD and obtain corresponding regression coefficients. Based on these regression coefficients, a scoring system was established and validated in both cohorts. RESULTS: Fifty-nine patients in the modeling cohort experienced DD. In the logistic regression analysis, pain involving V2 (P = 0.032), non-pear-shaped balloon (P = 0.029), history of radiofrequency therapy (P = 0.002), diabetes (P = 0.039), disease duration ≥ 8 years (P = 0.004), and herpes simplex virus infection (P < 0.001) were identified as independent risk factors for DD. A scoring system was established, consisting of the six variables above. Each factor was assigned a score, with the total score ranging from 0 to 11. The scoring system demonstrated good discriminative and calibration abilities. Using a cutoff score of 6, internal validation demonstrated satisfactory diagnostic sensitivity, specificity, accuracy, positive predictive value, negative predictive value, as well as strong discriminative and calibration capabilities. Analysis of the validation cohort confirmed the scoring system's diagnostic sensitivity (68.8%), specificity (79.6%), accuracy (76.9%), positive predictive value (52.4%), and negative predictive value (88.6%), with positive and negative likelihood ratios of 3.09 and 0.39, respectively. CONCLUSIONS: The scoring system we developed for predicting DD after PBC shows strong predictive ability and calibration. This tool is essential for improving postoperative evaluation and averting the need for retreatment.