{"id":"4f79c3f8-173f-4dfe-a1ef-684cc78c851b","slug":"homogeneous-groups-are-required-to-assess-the-effect-of-unilateral-thalamotomy-by-gamma-knife-radiosurgery-on-refractory-trigeminal-neuralgia","title":"Homogeneous groups are required to assess the effect of unilateral thalamotomy by Gamma Knife radiosurgery on refractory trigeminal neuralgia","authors":["Josef Finsterer"],"abstract":"Background: The article by Leal-Isaza et al. presents a retrospective observational study of 50 patients with trigeminal neuralgia treated with Gamma Knife radiosurgery (GKS) targeting the ipsilateral thalamus, contralateral thalamus, or retro-ganglionic portion of the trigeminal nerve. A reported satisfactory response was observed in 82% of patients, indicating a reduction in pain. Summary: The letter raises several concerns regarding the study's methodology, including the lack of clarity on whether thalamotomy or rhizolysis contributed to the positive outcomes. It also questions the impact of additional therapies received by patients and the significance of prior GKR treatments. Furthermore, the retrospective design of the study raises issues about missing data and its influence on results. Conclusion: To accurately assess the effectiveness of unilateral thalamotomy by GKR in refractory trigeminal neuralgia, it is imperative to study a homogeneous patient group that exclusively receives thalamic treatment without prior GKR interventions. Addressing the highlighted limitations could enhance the validity of the study's conclusions. Keywords: trigeminal neuralgia, Gamma Knife, thalamotomy, rhizolysis, retrospective study, pain management, neurosurgery","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/stereotactic.png","publishDate":"2025-10-31T00:00:00.000Z","doi":"10.25259/SNI_1048_2024","categories":["Stereotactic","Letter to the Editor"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/4f79c3f8-173f-4dfe-a1ef-684cc78c851b/pdf"}