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Updated: Apr 19, 2026

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
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[Thoracic outlet syndrome].

Masahiro Sonoo1

  • 1Department of Neurology, Teikyo University School of Medicine.

Brain and Nerve = Shinkei Kenkyu No Shinpo
|December 6, 2014
PubMed
Summary
This summary is machine-generated.

True neurologic thoracic outlet syndrome (TN-TOS) involves lower plexus compression, causing hand muscle weakness and specific nerve conduction abnormalities. Differentiating TN-TOS from other conditions like Hirayama disease is crucial for accurate diagnosis.

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Area of Science:

  • Neurology
  • Vascular Surgery
  • Orthopedics

Context:

  • Thoracic outlet syndrome (TOS) is a complex condition with debated definitions.
  • TOS encompasses five subtypes: arterial vascular, venous vascular, traumatic neurovascular, true neurologic (TN-TOS), and nonspecific TOS.

Purpose:

  • To clarify the definition and diagnostic criteria for true neurologic TOS (TN-TOS).
  • To differentiate TN-TOS from other TOS subtypes and conditions like Hirayama disease.

Summary:

  • TN-TOS results from lower plexus (T1>C8 roots/lower trunk) compression by a fibrous band.
  • Key symptoms include intrinsic hand muscle atrophy/weakness (thenar eminence, radial digital flexors), with variable sensory changes (ulnar forearm numbness).
  • Nerve conduction studies reveal characteristic findings: absent/attenuated medial antebrachial cutaneous nerve SNAP, and depressed median/ulnar CMAPs and SNAPs.

Impact:

  • Highlights the diagnostic significance of specific nerve conduction study findings in TN-TOS.
  • Suggests TN-TOS may be more common than previously recognized.
  • Underscores the challenges in diagnosing and the disputed existence of nonspecific TOS.