Association between trigeminal neuralgia and degenerative cervical myelopathy: A cross-sectional study using US data

Background: Limited research has suggested that trigeminal neuralgia (TN), an often-idiopathic pain disorder affecting the face and head, may arise from compression of the cervical spinal cord due to involvement of the spinal trigeminal tract. We hypothesized that adults with TN would have a greater likelihood of concurrent degenerative cervical myelopathy (DCM) compared to matched adults without TN.Methods: We retrieved de-identified data from a US network (TriNetX, Inc.) including medical records of >113 million patients, with a query date of October 1, 2023, and data spanning the previous 20 years. We created two groups of adults (aged >= 18 years): Those with (1) TN and (2) No TN, excluding individuals with predisposing conditions for TN (e.g., multiple sclerosis, ophthalmic and oral/maxillofacial surgery) and propensity matched for confounders (e.g., age, sex, body mass index, diabetes mellitus, hypertensive diseases, migraine, osteoporosis). We calculated the point prevalence and odds ratio (OR) of DCM with 95% confidence intervals (CI).Results: After matching there were 37,163 patients per group. The mean point prevalence of DCM in the TN group was 0.55% (95% CI: 0.47-0.63%) compared with 0.04% (0.03-0.06%) in the no TN group, yielding an OR of 12.94 (95% CI: 7.78-21.53; p < 0.0001).Conclusions: Adults with TN had more than 12 times greater odds of concurrent DCM compared to those without TN. These findings suggest that DCM may be a risk factor for TN, yet causality should be further examined using case-control or cohort designs.