Surgical nerve decompression for the relief of migraine symptoms is used to identify the compressed nerves in and around the head and remove the tight muscle, fascia, or other tissues. Compressed nerves cause pain and when the nerve is alleviated of the pressure, the pain improves. There are no implantable devices and the procedure is minimally invasive. The board-certified surgeons of the Migraine Relief Center have performed thousands of these procedures.
Recently some physicians have been using stem cells to aid in the recovery of the nerve compression, but there is no published data on whether this technology is effective.
Neurostimulators require the insertion of hardware and a battery. The idea behind a pain stimulator is to block the pain so it does not register with the brain. The nerve is still compressed, but now the signal is blocked. Anesthesiologists or pain management physicians perform these procedures. Pain management doctors gain very limited surgical/operative experience during their residency - at least much less than trained surgeons.
Both procedures have shown efficacy in reducing severity and duration of migraine headaches over time.
In a recent article titled, "Clinical Utility of Implantable Neurostimulation Devices in Treatment of Chronic Migraine" published on November 20, 2013 in a medical journal, the authors suggest that there is a high complication rate with implantation of these devices. Complications of migraine pain stimulators include:
- Lead migration: The long wire that connects from the battery in your back to your head actually moves out of place and therefore does not work anymore),
- Lead fracture: The wire breaks and therefore the connection is broken and it does not work
- Surgical site infections: The article states site infections remain high. It’s important to keep in mind that a device is being implanted which your body will consider foreign - keep in mind you are implanting a device which your body will consider foreign).
The journal also points out that in the pain stimulators used for migraine headaches in the U.S. are used as "off label.” In other words - the FDA has not approved them for that particular use, although they may be approved for other medical problems such as spinal cord injuries. It also suggests that the stimulators are safe and effective for refractory migraine cases. No conclusive evidence can be drawn at this time because more time and studies are required. A great study and opportunity would be to perform a head-to-head study comparing pain stimulators versus surgical nerve decompression for migraine headaches.
At the Migraine Relief Center we are helping to advance evidence based medicine when it comes to migraine surgery.