Ormseth Benjamin H, Kavanagh Kaitlin J, Saffari Tiam M, Palettas Marilly, Janis Jeffrey E
From the Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.
Department of Surgery, Rutgers New Jersey Medical School, Newark, N.J.
Plast Reconstr Surg Glob Open. 2024 Mar 14;12(3):e5629. doi: 10.1097/GOX.0000000000005629. eCollection 2024 Mar.
Trigger point deactivation surgery is a safe and effective treatment for properly selected patients experiencing migraine, with 68.3%-100% experiencing symptom improvement postoperatively. However, it is still unknown why certain patients do not respond. Obesity has been shown to be associated with worsened migraine symptoms and a decreased response to select pharmacotherapies. This study aimed to determine whether obesity may also be associated with an attenuated response to surgery.
A retrospective chart review was conducted to identify patients who had undergone trigger point deactivation surgery for migraine. Patients were split into obese and nonobese cohorts. Obesity was classified as a body mass index of 30 or higher per Centers for Disease Control and Prevention guidelines. Outcomes and follow-up periods were determined with respect to individual operations. Outcomes included migraine attack frequency, intensity, duration, and the migraine headache index. Differences in demographics, operative characteristics, and operative outcomes were compared.
A total of 62 patients were included in the study. The obese cohort comprised 31 patients who underwent 45 total operations, and the nonobese cohort comprised 31 patients who underwent 34 operations. Results from multivariable analysis showed no impact of obesity on the odds of achieving a more than 90% reduction in any individual outcome. The overall rates of improvement (≥50% reduction in any outcome) and elimination (100% reduction in all symptoms) across both cohorts were 89.9% and 65.8%, respectively.
Obese patients have outcomes comparable to a nonobese cohort after trigger point deactivation surgery for migraine.
触发点失活手术对于经适当选择的偏头痛患者是一种安全有效的治疗方法，术后有68.3%-100%的患者症状得到改善。然而，仍不清楚为何某些患者没有反应。肥胖已被证明与偏头痛症状加重以及对某些药物治疗的反应降低有关。本研究旨在确定肥胖是否也与手术反应减弱有关。
进行了一项回顾性病历审查，以确定接受偏头痛触发点失活手术的患者。患者被分为肥胖组和非肥胖组。根据疾病控制与预防中心的指南，肥胖被定义为体重指数达到30或更高。根据个体手术情况确定结果和随访期。结果包括偏头痛发作频率、强度、持续时间以及偏头痛头痛指数。比较了人口统计学、手术特征和手术结果的差异。
本研究共纳入62例患者。肥胖组包括31例患者，共进行了45次手术，非肥胖组包括31例患者，进行了34次手术。多变量分析结果显示，肥胖对任何个体结果实现超过90%降低的几率没有影响。两组的总体改善率（任何结果降低≥50%）和消除率（所有症状降低100%）分别为89.9%和65.8%。
偏头痛触发点失活手术后，肥胖患者的结果与非肥胖组相当。
