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Updated: Jul 10, 2026
06:57
Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
Thoracic outlet syndrome: a multidisciplinary problem with a perspective for microsurgical management without rib
S Rochkind1, M Shemesh, H Patish
1Tel Aviv Sourasky Medical Center, Division of Peripheral Nerve Reconstruction, Tel Aviv University, Tel Aviv, Israel. rochkind@zahav.net.il
Acta Neurochirurgica. Supplement
|November 8, 2007
Summary
Microsurgical neurovascular decompression effectively treats Thoracic Outlet Syndrome (TOS), with 82% of patients returning to normal activities. This approach offers significant symptom relief and improved quality of life for TOS patients.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Orthopedic Surgery
Background:
- Thoracic Outlet Syndrome (TOS) involves complex upper extremity symptoms due to brachial plexus and subclavian vessel compression.
- Current management lacks a definitive gold standard surgical procedure.
- TOS presents with pain, paresthesia, and potential neurological deterioration or vascular compromise.
Purpose of the Study:
- To evaluate the efficacy of microsurgical neurovascular decompression for Thoracic Outlet Syndrome.
- To assess symptom relief and functional recovery in patients treated with this microsurgical technique.
Main Methods:
- A cohort of 11 patients with TOS underwent microsurgical neurovascular decompression via a supraclavicular approach.
- Procedures included brachial plexus neurolysis, scalenectomy, and subclavian artery/vein release without rib resection.
- Patients were followed for 24-48 months, with outcomes assessed using a standardized scale.
Main Results:
- 9 out of 11 patients (82%) achieved good results, returning to normal physical activities with significant symptom relief.
- 2 patients (18%) experienced fair results, with reduced pain and medication reliance.
- 8 patients returned to full or partial employment; no poor results were reported.
Conclusions:
- Microsurgical neurovascular decompression using a supraclavicular approach is an effective treatment for TOS.
- This method provides symptom relief and facilitates a return to active daily life without cervical or first rib resection.
- The procedure demonstrates a high success rate in improving patient function and quality of life.
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