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Related Experiment Videos

Recurrent thoracic outlet syndrome after first rib resection.

K A Lindgren1, E Leino, M Lepäntalo

  • 1Rehabilitation Clinic, Kuopio University Central Hospital, Finland.

Archives of Physical Medicine and Rehabilitation
|March 1, 1991
PubMed
Summary

Recurrent thoracic outlet syndrome (TOS) after first rib resection is linked to monotonous desk work. Subluxated first rib stumps were more common in patients with persistent or recurrent TOS symptoms.

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Physical Therapy

Background:

  • Thoracic outlet syndrome (TOS) is a condition caused by compression of nerves or blood vessels in the thoracic outlet.
  • First rib resection is a common surgical treatment for TOS.
  • Long-term outcomes and recurrence factors after TOS surgery require further investigation.

Purpose of the Study:

  • To evaluate the long-term outcomes of first rib resection for TOS.
  • To identify factors associated with recurrent TOS symptoms after surgery.
  • To explore the role of occupational factors in TOS recurrence.

Main Methods:

  • A follow-up examination of 77 patients (84 operated limbs) approximately six years after first rib resection for TOS.
  • Assessment of symptom recurrence and persistence.

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  • Clinical examination, including the cervical rotation-lateral-flexion test, to identify subluxated first rib stumps.
  • Analysis of patient occupations and work-related activities.

    • Main Results:

    • 50% of limbs were asymptomatic one month post-operation, with 31 remaining asymptomatic at long-term follow-up.
    • 11 limbs experienced symptom recurrence.
    • Subluxated first rib stumps were significantly more prevalent in patients with persistent (17%) or recurrent (not specified but implied higher) TOS symptoms compared to asymptomatic patients (3%).
    • Monotonous desk work was identified as a potential contributing factor to kinesiologic abnormalities and TOS recurrence.

    Conclusions:

    • First rib resection can provide long-term relief for many TOS patients.
    • Subluxation of the first rib stump is a significant indicator of persistent or recurrent TOS.
    • Occupational factors, particularly monotonous desk work, may play a crucial role in the development of kinesiologic abnormalities leading to TOS recurrence even after surgical intervention.