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Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
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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
Summary
Thoracic outlet decompression significantly improves pain for many patients. However, depression and diagnostic challenges can impact outcomes, highlighting the need for better diagnostic tools.
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.
Keywords:
Brachial plexusCompressive neuropathyScalenectomyThoracic outlet decompressionThoracic outlet syndromeMore Related Videos
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