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Abstract 18: Predictors of Surgical Success and Failure in Migraine Surgery

Plastic and Reconstructive Surgery – Global Open: April 2016 - Volume 4 - Issue 4S - p 43
doi: 10.1097/01.GOX.0000488950.09162.40
PRS PSRC Podium Proofs 2016

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Lisa Gfrerer, MD, PhD,* Heather R. Faulkner, MD, MPH,† William G. Austen, Jr, MD†

From the *Harvard Medical School, Boston, Mass.; and †Massachusetts General Hospital, Boston, Mass.

PURPOSE: Migraine surgery improves symptoms in 68% to 95% of patients. However, predictors of surgical success and failure remain unknown.

METHODS: Forty subjects were prospectively enrolled and completed questionnaires on migraine history, migraine headache index (MHI) [migraine headache (MHA) frequency × duration × pain severity], migraine disability, headache impact test (HIT6), and pain self-efficacy questionnaire. After completing a 12-month follow- up, the “best” outcome patients [MHI 0 (no migraines), n = 11] and “worst” outcome patients (MHI > 100, n = 4) were grouped and analyzed.

RESULTS: Age of MHA onset was significantly higher in patients who failed surgery (37 vs 18.8 years); age at surgery was not significant. MHA duration was higher in non-responders (50 vs 17.8 hours), whereas pain severity and frequency were not. Factors signifying MHA severity (MHI total score, migraine disability, HIT6, and pain self-efficacy questionnaire scores) were not predictors of failure/success.

CONCLUSIONS: When comparing patients with the best and worst outcomes after migraine surgery, increasing age at MHA onset and longer MHA duration are negative predictors. These factors should be considered when screening patients for surgery.

© 2016 American Society of Plastic Surgeons