Impact of Socioeconomic Status on Need for Retreatment Following Percutaneous Balloon Ganglyolysis for the Treatment of Trigeminal Neuralgia

Introduction: Percutaneous balloon ganglyolysis (PBG) for trigeminal neuralgia (TN) is an inexpensive and minimally invasive treatment modality that has been shown to be effective for this severe pain syndrome. This is the first study to examine the effect that median annual income has on outcomes in this procedure.

Methods: We performed a retrospective study at a major academic institution from 2012-2023. TN patients who underwent PBG procedures for treatment were included in the analysis. Patients without imaging available from the PBG were excluded. The patient’s income was determined according to the median annual income corresponding to their zip code. We used $58,181 as the cutoff for “high annual income”. The success of treatment was determined based on the need for retreatment.

Results: Fifty-seven patients who underwent 89 procedures in total (39 retreatments) were included in the analysis. All patients had typical TN and were primarily female (61.4%), with a median age of 62. The high-income group contained 82% of the sample, while the low-income group made up the remaining 18%. We found no significant differences between the two groups in relation to age (p=.48), smoking status (p=.78), history of multiple sclerosis (p=.76), history of postherpetic neuralgia (p=.62), duration of TN pain (p=.89), foramen ovale morphology (p=.16), in addition to post-procedure numbness (p=.66). A trend toward significance was found in the immediate post-procedure pain control favoring the high-income group (p=.09) as well as the level of pain control during the follow-up period (p=.08). However, ultimately there was no significant difference in the need for retreatment between the two groups (p=.84).

Conclusion : This study shows that differences in socioeconomic status do not have a significant impact on the need for retreatment following Percutaneous balloon ganglyolysis (PBG) for the treatment of trigeminal neuralgia (TN).