Thoracic outlet syndrome in overhead athletes

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Neurosurgery

Background:

• Thoracic outlet syndrome (TOS) can significantly impact athletes, particularly those involved in overhead activities.
• Endoscopic first-rib resection is a surgical option for managing TOS.
• Comparing outcomes between athletic and non-athletic populations is crucial for understanding treatment efficacy.

Purpose of the Study:

• To compare clinical outcomes of endoscopy-assisted first-rib resection for TOS between overhead athletes and nonathletes.
• To investigate the rate of return to same-level sports in overhead athletes post-surgery.

Main Methods:

• Retrospective review of 181 patients (79 overhead athletes, 102 nonathletes) undergoing endoscopy-assisted first-rib resection.
• Transaxillary approach for rib resection and neurovascular decompression.
• Assessment using Roos and Disability of the Arm, Shoulder, and Hand (DASH) scores, and return-to-sport rates.

Main Results:

• Overhead athletes were younger, more frequently male, and had shorter symptom duration.
• Overhead athletes showed significantly higher excellent/good results on the Roos score (91.1% vs. 62.8%).
• Significant differences in preoperative and postoperative DASH scores and recovery rates were observed between groups.

Conclusions:

• Endoscopy-assisted transaxillary first-rib resection and neurolysis yield superior clinical outcomes in overhead athletes with TOS compared to nonathletes.
• The procedure demonstrates a high rate of return to same-level sports for overhead athletes.
• This surgical approach is effective for managing TOS in athletic populations.