Comparison of Gasserian ganglion conventional radiofrequency ablation and peripheral nerve pulsed radiofrequency in trigeminal neuralgia: a retrospective cohort study

TL;DR

This study compares two radiofrequency treatments for trigeminal neuralgia and finds that Gasserian ganglion conventional radiofrequency provides better long-term pain relief and higher patient satisfaction.

Contribution

The study provides a novel comparison of clinical outcomes between Gasserian CRF and peripheral PRF for trigeminal neuralgia.

Findings

Gasserian CRF provided significantly greater pain relief at 3 and 6 months compared to peripheral PRF.

Patients receiving Gasserian CRF reported significantly higher satisfaction scores.

Lower 6-month pain scores strongly predicted higher patient satisfaction.

Abstract

Background: Trigeminal neuralgia (TN) is a debilitating neuropathic
pain condition with profound quality of life impact. This study aims to compare
the clinical outcomes of Gasserian ganglion conventional radiofrequency (CRF) and
peripheral nerve pulsed radiofrequency (PRF) in patients with TN.
Methods: This retrospective cohort study included 74 patients with TN who
underwent radiofrequency ablation (RFA) between January 2015 and June 2025 at a
tertiary university pain clinic. Patients were divided into two groups: Group A
(Gasserian CRF, n = 37) and Group B (Peripheral PRF, n = 37). Numerical Rating
Scale (NRS) were recorded at baseline and at 1st, 3rd, and 6th months after
treatment. Patient satisfaction was evaluated using a 5-point Likert scale for
those with documented records. Results: Both groups showed significant
pain relief at the 1st month compared to baseline (p < 0.001 for
both). But, Group A showed significantly greater pain relief at the 3rd (3.54
± 2.21 vs. 5.51 ± 2.91; p = 0.0035) and 6th months
(3.19 ± 1.97 vs. 6.08 ± 3.06; p = 0.0001) than
Group B. Mean satisfaction scores were significantly higher in Group A (21.76
± 5.30) compared to Group B (14.19 ± 8.78), with a statistically
significant difference (p < 0.001). Likert scores correlated
strongly with 6-month NRS values (Spearman’s ρ = −0.91,
p = 0.002). Linear regression also confirmed that lower pain scores at 6
months significantly predicted higher satisfaction (β = −2.75,
R2 = 0.18, p = 0.003). Conclusions: Gasserian CRF
appears more effective than peripheral PRF to ensure long-term pain relief in TN,
and this may contribute to a trend toward higher patient satisfaction. Despite
its invasiveness, CRF remains a valuable option for TN management. These findings
support individualized procedural selection based on patient profiles and
therapeutic goals. Clinical Trial Registration: The study was retrospectively registered
on ClinicalTrials.gov (Identifier:
NCT07013500).

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