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Pneumothorax-II

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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
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Updated: Jul 20, 2025

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation

Published on: October 14, 2022

Long Thoracic Nerve Palsy: When Is Decompression Indicated.

Feiran Wu¹, Chye Yew Ng²

¹Birmingham Hand Centre, Queen Elizabeth Hospital, University Hospitals Birmingham, Mindelsohn Way, Birmingham, United Kingdom.

Journal of Hand Surgery Global Online

|July 31, 2023

Summary

This summary is machine-generated.

Long thoracic nerve palsy causing scapular winging may not always resolve spontaneously. Surgical decompression shows promise for patients with persistent symptoms, offering improved outcomes beyond the traditional 2-year observation period.

Keywords:

Long thoracic nerve Nerve decompression Neuralgic amyotrophy Scapular winging Serratus anterior

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Area of Science:

Neurology
Orthopedic Surgery
Nerve Entrapment Syndromes

Background:

Scapular winging, often caused by long thoracic nerve palsy, can result from trauma or non-traumatic events.
The conventional belief suggests spontaneous recovery within two years for most patients.
Emerging evidence indicates a less predictable natural history, with many experiencing residual weakness and fatigability.

Purpose of the Study:

To review the current understanding of long thoracic nerve palsy.
To explore diverse treatment strategies for scapular winging.
To analyze the outcomes associated with different interventions.

Main Methods:

Literature review of studies on long thoracic nerve palsy and scapular winging.
Analysis of surgical decompression techniques (thoracic, supraclavicular, combined).
Examination of outcomes reported for both conservative and surgical management.

Main Results:

A significant portion of patients experience persistent scapular winging, weakness, and fatigability beyond two years.
Surgical decompression of the long thoracic nerve, even after 12 months, has demonstrated satisfactory results.
Various surgical approaches yield positive outcomes, challenging the traditional conservative approach.

Conclusions:

The natural history of long thoracic nerve palsy is more complex than previously thought.
Proactive surgical intervention, including decompression, can be effective for persistent scapular winging.
Further research into optimal timing and techniques for surgical management is warranted.