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Outcomes after surgery for thoracic outlet syndrome
D A Axelrod1, M C Proctor, M E Geisser
1Department of Surgery, University of Michigan Hospitals, Ann Arbor, USA.
Journal of Vascular Surgery
|June 5, 2001
Summary
Psychological and socioeconomic factors like depression, marital status, and education impact outcomes for neurogenic thoracic outlet syndrome (N-TOS) surgery. Addressing these may improve patient results.
Area of Science:
- Neurosurgery
- Psychology
- Socioeconomics
Background:
- Neurogenic thoracic outlet syndrome (N-TOS) is a condition affecting the upper extremities.
- Operative treatment aims to decompress the brachial plexus.
Purpose of the Study:
- To investigate the association between psychological/socioeconomic factors and long-term outcomes of N-TOS surgery.
- Identify risk factors for persistent postoperative disability.
Main Methods:
- Retrospective review of clinical records, psychological tests, and follow-up questionnaires.
- Multivariate logistic regression analysis to identify independent risk factors.
Main Results:
- 170 patients underwent supraclavicular brachial plexus decompression with good initial outcomes.
- 65% reported symptom improvement, 64% satisfaction; however, 18% remained disabled.
- Preoperative depression, unmarried status, and low education were linked to persistent disability.
Conclusions:
- Surgical decompression benefits most N-TOS patients.
- Psychological and social factors significantly influence self-reported disability.
- Prospective studies on preoperative depression treatment are warranted.