Surgical outcomes of neurogenic thoracic outlet syndrome based on electrodiagnostic tests and QuickDASH scores

In total, 665 of 680 (97%) patients with neurogenic thoracic outlet syndrome (NTOS) improved with conservative treatment. The remaining (3%) patients (15 of 680 patients) did not benefit after 3 months of conservative treatment and were referred for transaxillary first rib resection. We retrospectively compared the preoperative and postoperative (3 months) electromyelography and Quick Disability of Arm, Shoulder and Hands results of operated NTOS patients. Three of the 15 (20%) patients in the surgical cohort were male, with a median age of 25.3 ± 4.16 years, and the other 12 patients (80%) were female with a median age of 31.9 ± 9.48 years. Two of the 15 patients had a cervical rib, 4 of the 15 patients had an extension of the C7 transverse process, and 14 of the 15 patients had a cervical band. These bone and tissue abnormalities were removed in addition to the first rib resection and division of the subclavius muscle and the anterior scalenus and middle scalenus muscles. QuickDASH scores were 1062 preoperatively and 549 postoperatively. The latency of the median F-wave was significantly prolonged on the affected side compared to the unaffected side preoperatively (p = 0.015). There was no remarkable difference in the latency of ulnar F-waves between sides (p = 0.246). The medial antebrachial cutaneous nerve response values increased significantly postoperatively (p < 0.0001). Significant increases in ulnar sensory nerve action potential values amplitude ratio (p < 0.003) and median nerve motor amplitudes (p < 0.0001) were also found postoperatively.