Nerve Decompression Surgery

http://www.medpagetoday.com/MeetingCoverage/IHC/40182

A plastic surgeon's passionate defense of his pioneering but controversial treatment for migraine failed to win many converts among headache specialists here.
...
Deborah Friedman, MD, of the University of Texas Southwestern Medical Center in Dallas, ... [said] that the treatment's real value could only be determined by a carefully designed, sham-controlled trial, and that the government would have to fund it.
...
Choosing his words carefully, [Debate moderator David Dodick, MD, of the Mayo Clinic in Scottsdale, Ariz.] closed the session by saying, "It appears to me that, after this excellent debate, the evidence is not sufficient according to the academic migraine neurologic community that, at least, we have in this room." He then endorsed Friedman's call for "better randomized, sham-controlled trials."

Isn't there some ethical problems with sham controlled trials when it comes to surgery?

Guess not here in the US. The participants would sign an informed consent.

That reminds me of the PFO heart trials for migraine where, as I recall, half the participants had a sham procedure and half didn't (although they were offered the real procedure at the end).