2026 Poster Presentations
P463: UNEQUAL ACCESS TO RELIEF: A SYSTEMATIC REVIEW OF HEALTHCARE DISPARITIES IN TRIGEMINAL NEURALGIA TREATMENT
Kelizmar Molina Negrón, BS1; Saahas Rajendran, BS2; Hadi Sultan, BS2; Mohammadmahdi Sabahi, MD, MPH3; Serdar Rahmanov, MD3; Qais Alrashidi, MD3; Ahmad Ahmadi, DMD4; Badih Adada, MD3; Hamid Borghei-Razavi, MD3; 1San Juan Bautista School of Medicine; 2Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA; 3Cleveland Clinic Florida; 4Nova Southeastern University
Objective: In patients with medically refractory trigeminal neuralgia (TN), non-medical modalities stereotactic radiosurgery (SRS), percutaneous rhizotomy, and microvascular decompression (MVD), are commonly employed. Despite extensive research on the outcomes and prognostic factors, there is limited literature on how health disparities influence treatment indication and allocation for patients. This systematic review evaluated healthcare disparities in terms of race, socioeconomic status (SES), age, gender, and their respective roles in determining treatment for TN.
Methods: A systematic literature search was carried out utilizing the MEDLINE (PubMed), Web of Science, Scopus, and Embase electronic databases from conception to June 2025 using PRISMA guidelines.
Results: Eleven articles were included in our study, encompassing a total of 13,137 patients, of whom 64% were male. Racial and ethnic disparities were observed, with Asian/Pacific Islander patients being more likely to undergo MVD, whereas Black patients were more likely to undergo rhizotomy compared with other treatments. African American patients were also observed to experience postoperative wound infections, higher pain scores, and a greater likelihood of recurrence compared with White patients. SES disparities were assessed using indicators such as insurance and income level. Higher SES was associated with a greater likelihood of receiving rhizotomy as a surgical treatment, greater access to high-volume centers, and improved treatment outcomes, while private insurance covered more MVD treatments. In terms of age and gender, older patients experienced poorer outcomes and the highest utilization of SRS as a medical intervention for TN.
Conclusion: This study revealed the presence of disparities in TN treatment based on race, SES, age, and gender. These disparities highlight the need for further research and interventions to ensure equitable access to appropriate surgical treatment for all patients with trigeminal neuralgia.