[Fascial spaces and recurrent surgery for thoracic outlet syndrome]

We studied the passive motion of the brachial plexus in relation to movement of the upper extremity by observation during surgery and by measurements in cadavers. The spaces for these movement are defined. The passive motion is provided by gliding tissue. Pathologic changes of the gliding tissue may contribute to the development of the symptoms of the TOS. It is distinguished between reversible and irreversible changes. A recurrent fibrosis may develop in rare cases which may be best treated by microsurgical neurolysis and envelopment of the brachial plexus by a gliding tissue flap.