PMID: 8600849Apr 1, 1996Paper

Thoracic outlet syndrome reconsidered

The American Surgeon
G V Poole, K R Thomae

Abstract

During a four year period, 50 patients were evaluated for possible thoracic outlet syndrome (TOS). These 11 men and 39 women ranged in age from 27 to 60 years, with a mean age of 38.6 years. Their symptoms had been present from 3 months to 10 years (mean = 2.1 years). Twenty-seven had previously undergone 33 operations, including carpal tunnel release, shoulder arthroscopy, rotator cuff repair, cervical discectomy, and first rib resection, all without benefit. Patients were evaluated by history, physical examination, and radiographs of the cervical spine and chest. Additional studies such as electromyography/nerve conduction studies, computed tomography, magnetic resonance imaging, angiography, and myelography were obtained selectively. Only 12 patients were thought to have TOS, seven of whom underwent operation. Four had complete resolution of symptoms; three were improved but had residual symptoms for associated problems. Three patients who were not thought to have TOS underwent first rib resection in other hospitals; none was improved after surgery. The only study of positive value was evidence of unilateral subclavian artery compression with shoulder positioning on physical examination. All other studies were of value only ...Continue Reading

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