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偏头痛手术治疗的安全性和疗效的全面综述

A Comprehensive Review of Surgical Treatment of Migraine Surgery Safety and Efficacy.

机构信息

From Vanderbilt University Medical Center; private practice; the University of Chicago; the American Society of Plastic Surgeons; and Johns Hopkins Plastic Surgery.

出版信息

Plast Reconstr Surg. 2020 Aug;146(2):187e-195e. doi: 10.1097/PRS.0000000000007020.

Abstract

BACKGROUND

Recent clinical experience with migraine surgery has demonstrated both the safety and the efficacy of operative decompression of the peripheral nerves in the face, head, and neck for the alleviation of migraine symptoms. Because of the perceived novelty of these procedures, and the paranoia surrounding a theoretical loss of clinical territory, neurologists have condemned the field of migraine surgery. The Patient Safety Subcommittee of the American Society of Plastic Surgeons ventured to investigate the published safety track record of migraine surgery in the existing body of literature.

METHODS

A comprehensive review of the relevant published literature was performed. The relevant databases and literature libraries were reviewed from the date of their inception through early 2018. These articles were reviewed and their findings analyzed.

RESULTS

Thirty-nine published articles were found that demonstrated a substantial, extensively replicated body of data that demonstrate a significant reduction in migraine headache symptoms and frequency (even complete elimination of headache pain) following trigger-site surgery.

CONCLUSIONS

Migraine surgery is a valid method of treatment for migraine sufferers when performed by experienced plastic surgeons following a methodical protocol. These operations are associated with a high level of safety. The safety and efficacy of migraine surgery should be recognized by plastic surgeons, insurance companies, and the neurology societies.

摘要

背景

最近的偏头痛手术临床经验表明,对面部、头部和颈部的外周神经进行手术减压是安全且有效的,可以缓解偏头痛症状。由于这些手术的新颖性,以及对理论上丧失临床领域的偏执,神经学家谴责偏头痛手术领域。美国整形外科学会患者安全小组委员会冒险调查了现有文献中偏头痛手术的已发表安全性记录。

方法

对相关文献进行了全面回顾。从成立之日起至 2018 年初,对相关数据库和文献库进行了回顾。对这些文章进行了回顾,并分析了它们的发现。

结果

发现了 39 篇已发表的文章,这些文章提供了大量广泛复制的数据,表明在触发点手术后,偏头痛症状和频率(甚至完全消除头痛)显著减少。

结论

当经验丰富的整形外科医生按照有条不紊的方案进行操作时,偏头痛手术是偏头痛患者的有效治疗方法。这些手术具有高度安全性。整形外科学家、保险公司和神经病学会应认识到偏头痛手术的安全性和有效性。

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