Robert A. Mericle, M.D.
Department of Neurological Surgery
Vanderbilt University Medical Center
B-1053 Preston Research Bldg.
Nashville, TN 37232-5345
615-322-7417
http://www.mc.vanderbilt.edu/surgery/neurosrg/Staff/Mericle/mericlebio.htm
Transcript: If a microvascular decompression fails, what’s next?
If you’ve had a previous microvascular decompression in the past and your pain has come back, you also have options as well. Certainly there’s the medication option and if we can get you in the place where we can control the pain with medication without side effects that’s great. If not, if you don’t want to take the medicines and you prefer the surgery then there’s several other options.
Depending on who did the microvascular decompression in the first place, if the surgery was done by somebody who’s an expert who does them all the time like at Vanderbilt, we do tons of them. And so, if you’re at a place where it’s done you know every week and you’re very, very good at finding the blood vessel compression area and that sort of thing then and if the pain still never got better meaning there wasn’t a blood vessel there possibly or there was a tiny thing there and it didn’t make the pain better, then if the pain is sharp and stabbing and severe and refractory, then a radiofrequency rhizotomy lesioning is a good option. If however your pain let’s say your pain did get better after previous microvascular decompression and it lasted several years, if it was done by somebody who’s not as nearly experienced who only does you know less than ten or so a year, then it might be that there, it would be worthwhile to have a repeat microvascular decompression because sometimes people will go in and not look all the way around the nerve you know. It’s very important to look all the way around the nerve on every side of it and make sure that there’s no blood vessel there and if there is one there make sure we get it off the nerve to decompress it and make the pain go away.