Peripheral nerve decompression surgery may be effective in reducing migraine headache frequency and intensity, according to a systematic review and meta-analysis published in the Annals of Plastic Surgery.
Investigators reviewed online databases for trials in which the efficacy of peripheral nerve surgery on migraine headaches was examined and included pain outcomes after surgery. A total of 23 studies in which interventions implicated different trigger sites with a total of 1151 patients with headache were analyzed. Migraine surgery was associated with a reduction in the frequency of migraine headaches in 616 individuals (random: mean, 9.52; 95% CI, 7.14-11.9; P <.00001) and a reduction in the intensity of migraine headache in 797 patients (random: mean, 3.97; 95% CI, 3.31-4.62; P <.00001). Complete elimination of headache after surgical intervention was reported by 8.3% to 76.4% of participants across all studies and 3.9% to 33.3% of participants reported no relief.
Study limitations include the lack of randomized controlled trials.
“Further clinical and anatomical studies are … needed to define the exact mechanism of nerve compression in [patients with] migraine and as to why a subset of patients does not respond to surgical treatment,” noted the review authors.
Nagori SA, Jose A, Roychoudhury A. Surgical management of migraine headaches: a systematic review and meta-analysis [published online December 13, 2018]. Ann Plast Surg. doi:10.1097/SAP.0000000000001743