After your trigeminal neuralgia diagnosis, your neurologist likely started you on certain medications to try to lessen or resolve your severe pain. In some cases, your doctor may have even tried several medications to treat your nerve pain disorder, including drugs like Trileptal, Tegretol or Gabapentin. Unfortunately, if you are not able to control your pain through these medications, you may need to turn to a surgical procedure to experience true relief. For patients who are fairly healthy despite their trigeminal neuralgia, the first line of surgical treatment is typically microvascular decompression.
Becoming familiar and comfortable with this type of procedure can best prepare you for your surgery. You likely have a fair number of questions, including:
- How is microvascular decompression performed?
- What is the average microvascular decompression procedure length?
- What is recovery after microvascular decompression like?
- Will your insurance cover microvascular decompression?
The following is an overview of each of these questions in order to help you decide if microvascular decompression may be a good solution for your trigeminal neuralgia.
How Is Microvascular Decompression Performed?
Microvascular decompression can be performed when a blood vessel is found to be impinging – or compressing – your trigeminal nerve. Radiological imaging can detect this type of impingement. At the start of the procedure, your anesthesiologist will administer general anesthesia. After you are sedated, a small incision will be made in the area behind your ear, to expose your skull. Next, your neurosurgeon will perform a craniectomy – creating a small hole in your head to gain access to your trigeminal nerve.
Once your surgeon locates your trigeminal nerve and the site of the impingement, he or she will use a small piece of surgical sponge to separate the nerve and the offending blood vessel. Then, a personalized piece of synthetic bone will be crafted to seal the defect in the bone and your skin will be stitched back into place. In a vast majority of cases, the steps of this procedure are successful in ending or greatly reducing trigeminal neuralgia pain.
What Is the Average Microvascular Decompression Procedure Length?
Microvascular decompression is considered major surgery, as it involves creating an opening within your head and exposing your brain. In cases without complications, you may be under anesthesia for 1-3 hours. If you have multiple areas of impingement or the impingement is hard to reach, the procedure may last longer.
What Is Recovery After Microvascular Decompression Like?
After surgery, you’ll first spend some time in the recovery room, as you are brought out from under your anesthesia. You’ll be monitored carefully to ensure your vital signs remain strong and no complications are detected. Once you are awake and stable, you’ll be moved to ICU, where you will remain under observation overnight.
You may experience some incisional pain after your microvascular decompression procedure. Pain medications can be administered in the hospital to help control this pain. You may also be sent home with a prescription for pain medication. The pain you feel after surgery will be different than the trigeminal neuralgia pain you experienced prior to the surgery. As the surgical pain lessens, you and your doctor will be able to determine if some or all of your trigeminal neuralgia pain has been solved.
After your procedure, you’ll need to spend significant time resting, interspersed with activities like walking slowly to rebuild your strength. You should not drive a car during the weeks after your trigeminal neuralgia surgery, both because of the effect of pain medication as well as your lack of strength as your body heals. Work with your friends and family to gain the support you need during your recovery. It is extremely important that you not overdo it while you are recovering from your microvascular decompression.
Will Your Insurance Cover Microvascular Decompression?
Many insurance companies and policies cover microvascular decompression for patients with trigeminal neuralgia. In order to obtain coverage, you can work with the insurance specialists at your neurosurgeon’s practice to complete pre-authorization paperwork. Often, authorization can be obtained after the first request. Work with your neurosurgeon’s insurance specialists and representatives from your insurance companies to ensure they have all of the necessary information, including case history and radiology results, to authorize your procedure.
Deciding on Microvascular Decompression
Microvascular decompression is commonly recommended by neurosurgeons because it provides total or near-total relief in a large percent of patients. Now that you’ve learned more about the microvascular decompression procedure length and what you can expect, you can make an educated decision with your medical professional, and be well on your way to eliminating your trigeminal neuralgia pain for good.
