Nerve Decompression Surgery Studies “Not Convincing”

Nerve decompression surgery (known as migraine trigger site deactivation) has been widely touted in the general media as an effective migraine treatment, but migraine researchers have remained skeptical of its efficacy. Harvard Medical School researchers have found that the data supporting this surgery are “not convincing,” according to a study that will be presented at the American Headache Society’s 56th Annual Scientific Meeting next week.

Migraine trigger site deactivation surgery is used for migraine prevention and includes surgical procedures on four sites: intranasal, frontal, temporal and occipital.

Lead researcher Paul G. Mathew, M.D. summarizes his study findings best:

“Plastic surgery studies have suggested that these procedures have high efficacy, but our evaluation reveals numerous methodological flaws including unclear patient selection and inconsistent endpoints.”

“In addition to unclear efficacy, these procedures can also have complications including worsening pain and permanent itching. They can have an out-of- pocket cost of $10,000-$15,000 which is often not covered by insurance. Our research shows that MTSDS [migraine trigger point deactivation surgery] should be considered experimental at best, and that patients considering it should have it performed as part of a clinical trial.”

This and other professional discussions of this surgery have called studies published supporting these surgeries to be deeply flawed. Issues include patients who may or may not have had migraine, non-blinded studies, lack of control groups, no accounting for headache medication, among other issues.1 All these issues add up to unreliable research findings.

Headache specialists who have spoken out against trigger site deactivation surgery believe published study findings indicate a high placebo response.2 While a placebo response may seem better than no response at all, they don’t tend to last. With a surgery that could worsen pain or cause permanent itching, it’s a big risk to take.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
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