Neurogenic thoracic outlet syndromes

Title
Neurogenic thoracic outlet syndromes: a comparison of true and nonspecific syndromes after surgical treatment.
Source
Surgical Neurology. 65(3):262-71; discussion 271-2, 2006 Mar.



BACKGROUND:
Neurogenic thoracic outlet syndrome (NTOS) is attributed to compression of the brachial plexus at the scalene hiatus. Patients with true NTOS (TNTOS) have typical clinical and electrophysiological changes and are considered to respond well to surgical treatment, but patients with nonspecific NTOS (NNTOS) have predominantly sensory signs, not well-defined electrophysiological changes, and are thought not to respond favorably to surgical treatment. The postsurgical outcome of patients with cervicobrachialgia diagnosed as TNTOS and as NNTOS is analyzed.


RESULTS:
Improvement of pain/paresthesias, sensory loss, atrophy, and muscular weakness after surgery was similar in the two groups. Regarding functional capacity, 57.1% of patients with TNTOS and 63.6% of patients with NNTOS became normal or reacquired their previous condition with slight limitation. Surgery-related complications were paresthesias and paresis in the arm, sympathetic dystrophy, pneumothorax, and lymphatic collections, all in patients with NNTOS.



CONCLUSIONS:
Patients with NNTOS with electrophysiological signs of extraspinal radicular impairment had the same chances of improvement after surgical treatment as patients with TNTOS.