05 Jan Migraine Surgery Markedly Reduced Pain Intensity and Disability

MedicalResearch.com Interview with:
Lisa Gfrerer, MD PhD
Clinical Fellow in Surgery
Brigham and Women’s Hospital
William Gerald Austen MD
Chief, Plastic and Reconstructive Surgery
Chief, Division of Burn Surgery
Massachusetts General Hospital

 MedicalResearch.com: What are the main findings?

Response: Migraine surgery patients at our institution are chronic pain patients who have failed conservative therapy and are severely disabled by their disease.

We initiated this study to understand two important points. First, it was previously unclear how to categorize these patients in terms of pain intensity and disability on the spectrum of better known pain conditions such as chronic back pain/ nerve pain/ carpal tunnel.  This is very important to appreciate the extent of this disease. Second, instead of collecting migraine characteristic such as decrease in migraine days/ duration/ pain, we wanted to understand how functionally disabled these patients are in their daily lives and how much better they get after surgery. This is ultimately what matters to patients.

We therefore decided to evaluate our outcomes by using the Pain Self Efficacy Questionnaires (PSEQ). This validated pain questionnaire has been used to describe pain intensity/disability in patients with different acute and chronic pain conditions.

MedicalResearch.com: What are the main findings?

Response: We found that the mean preoperative PSEQ score in migraine surgery candidates was 18.2 ± 11.7, which was extremely poor compared to severe chronic pain with neuropathic character (26.4 ± 16.0), chronic back pain (36 to 44) and  carpal tunnel (45 ± 12). By this comparison the magnitude of debility in migraine surgery patients becomes apparent.  Further, we found that PSEQ scores in migraine patients improved by 112% after surgery, which is much higher than  pain improvement seen in other pain conditions after therapy.

MedicalResearch.com: What should readers take away from your report?

Response: Migraine surgery candidates are severely disabled by their disease. They are even more incapacitated  than patients with severe chronic nerve pain (average pain ≥7 for >6 months).  However, migraine surgery patients can improve pain intensity/ disability by 112% after surgery (on average). Their extent of debility and ability to improve is quite astonishing.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Future research should focus on better characterization of migraine surgery patients and better tools to evaluate outcomes.  

MedicalResearch.com: Is there anything else you would like to add?

Response: Future research should focus on better characterization of migraine surgery patients and better tools to evaluate outcomes.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Ability to Cope with Pain Puts Migraine Surgery Patients in Perspective

Gfrerer, Lisa M.D., Ph.D.; Lans, Jonathan M.D.; Faulkner, Heather R. M.D., M.P.H.; Nota, Sjoerd M.D., Ph.D.; Bot, Arjan G. J. M.D., Ph.D.; Austen, William Gerald Jr. M.D.
Plastic and Reconstructive Surgery: January 2018 – Volume 141 – Issue 1 – p 169–174
doi: 10.1097/PRS.0000000000003955

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. 

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Last Updated on January 5, 2018 by Marie Benz MD FAAD