Percutaneous retrogasserian glycerol rhizotomy for trigeminal neuralgia: an alternative technique

Background: One of the challenges faced by the modern-day NHS is workplace shortages, and experienced radiographers for intra-operative neurosurgical imaging is one such scenario. We describe our method for Percutaneous Retrogasserian Glycerol Rhizotomy (PRGR) using frameless neuronavigation which can be used effectively in such scenarios. Method: Stealth neuronavigation is used for needle placement within the foramen ovale and injection of glycerol, under sedation. Results: In our experience of ten procedures, it is accurate, safe and effective. Good results were obtained on all occasions. It can be repeated as often as necessary using the same Stealth((R)) CT scan and reduces exposure for staff and patients, where repeated injections are required. Conclusion: This simple modification of PRGR technique is effective and safe provided the surgeon has previous experience in undertaking this procedure.