Predictors of Postoperative Complications After Microvascular Decompression for Trigeminal Neuralgia and Hemifacial Spasm: A Retrospective Cohort Study

BACKGROUND: Microvascular decompression (MVD) is a definitive treatment for trigeminal neuralgia and hemifacial spasm, but a subset of patients experiences postoperative complications. Identifying risk factors for these complications could improve perioperative management and patient counseling. METHODS: We retrospectively analyzed 453 patients who underwent MVD for classic trigeminal neuralgia or hemifacial spasm from January 2020 to March 2024 at the First Affiliated Hospital of Anhui Medical University. Univariate analyses compared patients with versus without complications. Multivariate logistic regression was performed to identify independent predictors. Model performance was assessed with bootstrapped internal validation (1000 resamples), concordance index (C-index/area under ROC curve), and calibration analysis. A nomogram was constructed based on the final model. RESULTS: In multivariate logistic analysis, elevated preoperative glucose (adjusted OR = 2.63 per 1 mmol/L increase, 95% CI: 1.96-3.66, P