Comparison of Gasserian ganglion conventional radiofrequency ablation and peripheral nerve pulsed radiofrequency in trigeminal neuralgia: a retrospective cohort study

Background: Trigeminal neuralgia (TN) is a debilitating neuropathic pain condition with profound quality of life impact. This study aims to compare the clinical outcomes of Gasserian ganglion conventional radiofrequency (CRF) and peripheral nerve pulsed radiofrequency (PRF) in patients with TN. Methods: This retrospective cohort study included 74 patients with TN who underwent radiofrequency ablation (RFA) between January 2015 and June 2025 at a tertiary university pain clinic. Patients were divided into two groups: Group A (Gasserian CRF, n = 37) and Group B (Peripheral PRF, n = 37). Numerical Rating Scale (NRS) were recorded at baseline and at 1st, 3rd, and 6th months after treatment. Patient satisfaction was evaluated using a 5-point Likert scale for those with documented records. Results: Both groups showed significant pain relief at the 1st month compared to baseline (p < 0.001 for both). But, Group A showed significantly greater pain relief at the 3rd (3.54 ± 2.21 vs. 5.51 ± 2.91; p = 0.0035) and 6th months (3.19 ± 1.97 vs. 6.08 ± 3.06; p = 0.0001) than Group B. Mean satisfaction scores were significantly higher in Group A (21.76 ± 5.30) compared to Group B (14.19 ± 8.78), with a statistically significant difference (p < 0.001). Likert scores correlated strongly with 6-month NRS values (Spearman’s ρ = −0.91, p = 0.002). Linear regression also confirmed that lower pain scores at 6 months significantly predicted higher satisfaction (β = −2.75, R2 = 0.18, p = 0.003). Conclusions: Gasserian CRF appears more effective than peripheral PRF to ensure long-term pain relief in TN, and this may contribute to a trend toward higher patient satisfaction. Despite its invasiveness, CRF remains a valuable option for TN management. These findings support individualized procedural selection based on patient profiles and therapeutic goals. Clinical Trial Registration: The study was retrospectively registered on ClinicalTrials.gov (Identifier: NCT07013500).

Trigeminal neuralgia; Conventional radiofrequency; Peripheral nerve; Pulsed radiofrequency; Patient satisfaction; Pain relief

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