Clinical presentations and surgical outcomes of hemifacial spasm involving the vertebral artery

Abstract ObjectivesWe aimed to determine whether vertebral artery (VA) affects the success rate of microvascular decompression(MVD) in hemifacial spasm(HFS) patients. We compared the clinical presentations and surgical outcomes between VA-involved and non-VA HFS patients.MethodsThe study comprised 313 HFS patients who underwent MVD between January 2015 and December 2018. There were 59 patients in the VA-involved group and 254 patients in the non-VA group. The clinical results mainly included the rate of HFS remission and the complications. Postoperative neurosurgery-related problems and neurological issues were among the complications.ResultsAmong the 313 enrolled patients, 288 were spasem-free: 52 (88%) in VA-involved group and 236 (91.4%) in non-VA group. Delayed and partial remissions were frequent in VA-involved group. Furthermore, VA was significantly associated with partial remission ( P =0.014). The total rate of complications was comparable between the two groups. However, motor or sensory impairments mainly occurred in the VA-involved group.ConclusionsThe rates of long-term remission and overall complication after MVD were not significantly different between the groups. VA-involved HFS may be at high risk for severe neurological complications and the partial spasem-free.