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[Thoracic outlet syndrome].

A Dubuisson1, M Foidart-Dessalle, A Cohnen

  • 1Service de Neurochirurgie, CHU de Liège.

Revue Medicale De Liege
|April 11, 2001
PubMed
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Thoracic outlet syndrome (TOS) involves compression of nerves and vessels in the neck and arm. Treatment typically starts with conservative physical therapy, progressing to surgery if symptoms persist or worsen.

Area of Science:

  • Neuroscience
  • Vascular Surgery
  • Orthopedics

Context:

  • Thoracic outlet syndrome (TOS) is a complex condition involving compression of neurovascular structures.
  • The interscalene triangle is the most common site for this entrapment.
  • TOS presents diagnostic and treatment challenges, with debated incidence and criteria.

Purpose:

  • To outline the pathophysiology, clinical presentation, diagnostic approaches, and management strategies for TOS.
  • To highlight the controversial nature of TOS diagnosis and treatment.
  • To discuss the role of conservative and surgical interventions.

Summary:

  • TOS results from brachial plexus or subclavian vessel compression, often due to anatomical factors or trauma.
  • Symptoms include arm pain, paresthesias, weakness, and vascular changes, often exacerbated by overhead arm positions.

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  • Diagnosis relies on clinical evaluation, excluding other pathologies, and may involve imaging and electrophysiology.
  • Conservative treatment with physical therapy is preferred unless significant deficits or unresponsive symptoms necessitate decompressive surgery, often via an anterior supraclavicular approach.

    • Impact:

    • Provides a comprehensive overview for clinicians managing TOS patients.
    • Emphasizes the importance of a thorough clinical assessment and tailored treatment plans.
    • Informs understanding of TOS etiology, presentation, and current therapeutic options, including surgical advancements.