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Updated: Aug 24, 2026

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
[Rehabilitation of thoracic outlet syndrome: about 60 patients]
Khalil Ghoussoub1, Georges Tabet, Ziad Zoghby
1Services de Medecine physique, Hôpital Hôtel-Dieu de France, Beyrouth, Liban. kgsoub@yahoo.com
Abstract:
Sixty patients were treated by physical therapy for thoracic outlet syndrome (TOS) between 1995 and 1999. Females were predominant (76%), the average age was 34.5 years (18 to 60). Risk factors were: hypermobility, cervical traumatism and profession. Neurological signs were predominant and positive provocation tests were found: Adson (48%), sonnette (62%), E.A.S.T. (51%). Thoracic pain inaugurated the symptoms in 3 times: pseudo-angina (2), dyspnea (1). Radiological results were positive for: cervical rib (8), apophysomegaly of C7 (25), clavicular traumatism (1). Electromyogram was positive in 2 out of 3 patients, RMI in 2 of 4, and dynamic echo Doppler in 3 of 4. After rehabilitation, immediate results were satisfactory in more than 70% of cases. After six months one patient had recurrence of symptoms, 66% were compliant with treatment, and 84% were satisfied. At one year the symptoms recurred in 2 patients, 15% were still compliant, and 81% were satisfied. Surgery was needed in 4 patients with cervical ribs.

