Migraine Surgery and Determination of Success over Time by Trigger Site: A Systematic Review of the Literature

Background:Migraine headache is a debilitating disorder that produces high costs and compromises patient quality of life. This study aimed to evaluate surgery success and the longevity of the surgical benefit by trigger site. Methods:A systematic literature review was performed by querying the PubMed, Embase, Scopus, and Web of Science databases. The keywords surgery, migraine, outcomes, headache index, and synonyms in titles and abstracts were used to perform the search. Results:A total of 17 articles published between 2009 and 2019 met the inclusion criteria. Six studies were prospective and 11 were retrospective. Most of the studies (77.8%, 77.8%, and 80%, respectively) reported success of migraine surgery at 12-month follow-up for trigger sites I, II, and III, respectively. For trigger site IV, the greatest Migraine Headache Index reduction (93.4%) was observed at 12-month follow-up, and the earliest Migraine Headache Index reductions (80.3% and 74.6%) were observed at 6-month follow-up. All studies that evaluated trigger sites V and VI identified surgery success at 12-month follow-up. Migraine surgery was found to remain beneficial at 22 months for trigger sites I, II, III, and IV. Conclusions:The symptomatic improvement may initially be evident at 6 months for trigger site IV and at 12 months for trigger sites I, II, III, V, and VI. Surgical benefit in trigger sites I, II, III, and IV can persist after 22 months. Further studies are required to evaluate results at longer follow-up.

Automated summary

Surgical treatment for migraines can provide symptomatic improvement and enhance quality of life, especially within the first 12 months after surgery for certain trigger sites. Additionally, surgical benefits can persist after 22 months for specific trigger sites.