P.126 Cyberknife radiosurgery for trigeminal neuralgia: a retrospective review of 168 cases
Bibliographic record
Abstract
Background: Gamma Knife radiosurgery for the treatment of refractory trigeminal neuralgia is recognized as an efficient intervention. The CyberKnife, a more recent frameless radiosurgery alternative, has not been studied as extensively for this condition. The aim of this study is to evaluate the clinical outcomes of a first CyberKnife radiosurgery treatment on patients with medically refractory trigeminal neuralgia. Methods: A retrospective study of 166 patients (168 cases) with refractory trigeminal neuralgia treated since 2009 with CyberKnife radiosurgery at the Centre Hospitalier de l’Université de Montreal (CHUM). Results: Adequate pain relief (Barrow Neurological Institute (BNI) pain scores I-IIIb) was achieved in 146 cases (86.9%). The median latency period before adequate pain relief was 35 days (range 0-202 days). The median duration of adequate pain relief was 15.8 months (range 0.6-85.0[DR1] [AG2] [AG3] [AG4] months). The actuarial rates of maintenance of adequate pain relief at 12, 36, and 60 months were 77.0%, 62.5%, and 50.2%, respectively. There was a new-onset or aggravation of facial numbness in 44 cases (26.2%). The maintenance of an adequate pain relief was more sustained in idiopathic cases in comparison to cases associated with multiple sclerosis ( P< 0.001). Conclusions: In our experience CyberKnife radiosurgery for refractory trigeminal neuralgia is efficacious and safe.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 0.005 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.002 | 0.000 |
| Research integrity | 0.000 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".