To investigate the clinical efficacy and safety of percutaneous balloon compression (PBC) and microvascular decompression (MVD) in the treatment of primary trigeminal neuralgia in the elderly.

The clinical data of elderly patients with trigeminal neuralgia treated with MVD (25 cases) or PBC (28 cases) from January 2019 to December 2019 were retrospectively analyzed. The chi-square test or Fisher exact probabilities was used to compare the surgical efficacy and complications between the two groups, and the t-test was used to compare the length of stay and hospitalization costs between the two groups.

There was no significant difference between PBC group and MVD group in surgical cure rate (67.9% vs 68.0%), and effective rate (85.7% vs 96.0%) (all P＞0.05). The operation time of PBC group was significantly shorter than that of MVD group [(56±17)min vs (141±29)min, t=6.277, P＜0.001]; the length of hospital stay was shorter than that of MVD group [(6±2)d vs (16±5)d, t=9.199, P＜0.001], and the hospitalization cost was lower than that of MVD group [(24110±5941)yuan vs (27648±5523)yuan, t=0.615, P=0.030]. The incidence of facial numbness, facial swelling and trigeminal nerve inhibition in the PBC group were higher than those in the MVD group [85.7%(24/28) vs 8.0%(2/25); 21.4%(6/28) vs 0; 21.4%(6/28) vs 0], while the incidence of postoperative febrile reaction was lower than that in the MVD group [0 vs 76.0%(19/25)], the differences were statistically significant (P<0.001; χ²=4.095, P=0.043; χ²=4.095, P=0.043; χ²=33.172, P＜0.001).

Both MVD and PBC surgery can effectively treat primary trigeminal neuralgia in elderly patients. Compared with MVD surgery, PBC surgery is simpler, safer and more effective in the treatment of primary trigeminal neuralgia.