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Meta-Analysis
. 2024 Oct 1;110(10):6306-6313.
doi: 10.1097/JS9.0000000000001480.

Surgical interventions for intractable migraine: a systematic review and meta-analysis

Tahani Alrahbeni  1 , Ahmed Mahal  2 , Anas Alkhouri  3 , Hadil F Alotaibi  4 , Vineet Rajagopal  5 , Ashish Behera  6 , Khalid Al-Mugheed  7 , Mahalaqua N Khatib  8 , Shilpa Gaidhane  9 , Quazi S Zahiruddin  10 , Muhammed Shabil  11   12 , Ganesh Bushi  11   12 , Sarvesh Rustagi  13 , Neelima Kukreti  14 , Prakasini Satapathy  15   16 , Ranjan K Mohapatra  17 , Arkadiusz Dziedzic  18 , Bijaya K Padhi  5
Affiliations
Meta-Analysis

Surgical interventions for intractable migraine: a systematic review and meta-analysis

Tahani Alrahbeni et al. Int J Surg. .

Abstract

Background: Migraine affects ~14-15% of the global population, contributing to nearly 5% of the world's health burden. When drug treatments prove ineffective for intractable migraines, highly specific surgical interventions emerge as potential solutions. The authors aimed to analyze surgical approaches for these refractory or intractable migraines through a systematic review and meta-analysis.

Methods: The authors conducted a literature search across databases such as PubMed, Scopus, Web of Science, and Embase, focusing on studies related to migraines and surgical outcomes. The authors considered clinical trials or observational studies that included any surgical intervention for refractory or intractable migraines, emphasizing key outcomes such as reductions in migraine intensity, Migraine Disability Assessment scores (MIDAS), and 50% Migraine Headache Index (MHI) reduction rates. Statistical analyses were performed using R version 4.3.

Results: Eleven studies were included in the systematic review. A meta-analysis of four studies involving overall 95 patients showed a significant reduction in mean migraine intensity scores using ONS (-2.27, 95% CI: -3.92 to -0.63, P =0.021). Three studies with 85 patients showed an average MIDAS score reduction of -52.3, though this was not statistically significant (95% CI: -136.85 to 32.19, P =0.116). Two additional studies corroborated these reductions in MIDAS scores. Nerve decompression surgery showed a substantial decrease in the average migraine intensity (from 8.31 down to 4.06). Median MIDAS score dropped from 57 to 20. Two studies indicated a success rate of 40 and 82%, respectively, in achieving a 50% reduction in the migraine MHI through nerve decompression. Findings from two studies suggest that septorhinoplasty and sinus surgery effectively decrease migraine intensity scores.

Conclusion: The existing evidence emphasizes the potential advantages of surgical interventions as a promising approach to managing intractable or refractory migraines. However, robust and comprehensive research is crucial to refine and solidify the efficacy of these surgical methods, aiming for widespread benefits for patients, considering cost-effectiveness factors.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram depicting screening and selection of studies.
Figure 2
Figure 2
Forest plot depicting the mean difference in migraine intensity presurgery and postsurgery.
Figure 3
Figure 3
Forest plot depicting the mean difference in MIDAS score presurgery and postsurgery.
See this image and copyright information in PMC

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References

    1. Amiri P, Kazeminasab S, Nejadghaderi SA, et al. . Migraine: a review on its history, global epidemiology, risk factors, and comorbidities. Front Neurol 2022;12:800605; 2553. - PMC - PubMed
    1. Straube A, Andreou A. Primary headaches during lifespan. J Headache Pain 2019;20:1–14. - PMC - PubMed
    1. Andreou AP, Edvinsson L. Mechanisms of migraine as a chronic evolutive condition. J Headache Pain 2019;20:1–17. - PMC - PubMed
    1. Matilde L, Raggi A. A narrative review on the burden of migraine: when the burden is the impact on people’s life. J Headache Pain 2019;20:41. - PMC - PubMed
    1. Steiner TJ, Stovner LJ. Global epidemiology of migraine and its implications for public health and health policy. Nat Rev Neurol 2023;19:109–117. - PubMed