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Treatment Delay in Patients Undergoing Headache Surgery (Nerve Decompression Surgery)
Merel H J Hazewinkel1,2, Katya Remy3, Leonard Knoedler3
1Weill Cornell Medicine, Division of Plastic and Reconstructive Surgery, New York, NY.
JPRAS Open
|November 6, 2023
Summary
Patients wait 20 years for headache surgery, which significantly reduces pain and healthcare costs. Integrating surgical options into headache management algorithms is recommended for better patient outcomes.
Area of Science:
- Neurosurgery
- Pain Management
- Health Economics
Background:
- Headache surgery is effective for refractory headache disorders but often overlooked by non-surgical providers.
- A significant delay exists between headache disorder onset and surgical intervention.
- Current management algorithms may not adequately incorporate surgical options.
Purpose of the Study:
- To evaluate the delay in surgical management for patients with headache disorders.
- To conduct a cost-comparison analysis between conservative and operative headache treatments.
- To report on the surgical outcomes of headache surgery.
Main Methods:
- Screened 1112 patients, with 271 undergoing headache surgery.
- Prospectively collected data on headache disorder onset and pain characteristics.
- Calculated direct and indirect costs of conservative headache management.
Main Results:
- Median delay to surgery was 20 years.
- Annual conservative treatment cost averaged $49,463.78 per patient.
- Headache surgery cost $11,000, with significant reductions in pain days, intensity, and duration (p<0.001).
Conclusions:
- Patients endure headache symptoms for approximately 20 years before surgery.
- Headache surgery offers substantial pain improvement and healthcare cost reduction.
- Surgical treatment should be integrated into headache disorder management algorithms.
