Sheba Medical Center Launches Minimally Invasive Surgery to Relieve Chronic Migraine Nerve Pressure
Sheba Medical Center in Israel has introduced a pioneering minimally invasive micro-surgical procedure for patients suffering from chronic migraines unresponsive to conventional treatments. This novel service, the first of its kind in Israel, targets the release of pressure on sensory nerves in the head and face, identified as the anatomical "trigger point" where pain originates due to irritation or compression by muscles, connective tissue, or blood vessels. The surgery involves microscopically locating and gently freeing the affected nerve to alleviate pain.
The procedure is led by Dr. Iman Khoury, a senior hand and peripheral nerve surgeon at Sheba, who trained under Professor David Chwei-Chin Chuang in Taiwan. Dr. Khoury explains that migraines severely impact quality of life, with some patients experiencing debilitating pain for several days each month, affecting work, social life, and daily functioning. The complex neurological condition involves nerve stimulation and vascular factors, and while various medications, biological treatments, and Botox injections exist, many patients continue to suffer or face diminishing treatment effects and side effects.
Botulinum toxin injections, a common treatment for chronic migraine, require repeated administration every three to six months and can be costly, sometimes reaching thousands of shekels privately. For patients who do not achieve sufficient relief from medications or Botox, the new surgical option is considered after thorough evaluation. This includes detailed patient history, physical examination, and diagnostic nerve blocks to confirm the nerve's involvement.
The surgery typically lasts 45 minutes to an hour, involving a small incision within the hairline to expose and decompress the nerve. Postoperative recovery takes about two weeks, with precautions to avoid sun exposure and water activities for six weeks to minimize scarring. Potential risks include bleeding, infection, sensory changes, and nerve injury. Studies on carefully selected patients have shown up to 85% reduction in pain intensity and 70% decrease in attack frequency, improving patients' quality of life. However, the surgery is not a first-line treatment but an option for select cases after specialist consultation and failure of standard therapies.
