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Patient-Reported Outcomes from Supraclavicular Thoracic Outlet Decompression.

Kazimir R Bagdady1, Jacob A Thayer2, Jaclyn Bredenkamp3

  • 1Division of Plastic and Reconstructive Surgery, Department of Surgery, Saint Louis University School of Medicine, Saint Louis, MO.

Journal of Hand Surgery Global Online
|December 8, 2025
PubMed
Summary
This summary is machine-generated.

Thoracic outlet decompression significantly improves pain for many patients. However, depression and diagnostic challenges can impact outcomes, highlighting the need for better diagnostic tools.

Keywords:
Brachial plexusCompressive neuropathyScalenectomyThoracic outlet decompressionThoracic outlet syndrome

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Area of Science:

  • Neurosurgery
  • Orthopedics
  • Vascular Surgery

Background:

  • Neurogenic thoracic outlet syndrome diagnosis relies on history, maneuvers, and surgical decompression outcomes.
  • Patient-reported outcomes after thoracic outlet decompression require further investigation.

Purpose of the Study:

  • To evaluate patient-reported outcomes following surgical decompression for thoracic outlet syndrome.
  • To identify factors influencing symptom improvement after thoracic outlet decompression.

Main Methods:

  • A retrospective review of patients undergoing thoracic outlet decompression (July 2015-July 2020).
  • Utilized validated questionnaires: Thoracic Outlet Syndrome Index, SF-20, Pain Catastrophizing Scale (PCS), Zung Depression Scale.
  • Collected patient-reported outcomes from 10 individuals.

Main Results:

  • Average scores: TOSI 63, Zung 58.25, SF-20 pain 40.3, PCS 22.6.
  • 100% reported some depression; 50% mild, 50% moderate.
  • 50% experienced ≥95% pain improvement; 60% reported residual numbness.

Conclusions:

  • Thoracic outlet decompression effectively improves pain, but outcomes can be affected by depression, pain catastrophizing, and diagnostic accuracy.
  • Development of more objective diagnostic tests for thoracic outlet syndrome is needed.
  • Identifying patients likely to benefit from surgery requires further research.