Related Experiment Video
Updated: Jan 22, 2026
06:57
Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome
Published on: September 13, 2020
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Outcomes of endoscopic, thoracic segment long thoracic nerve decompression
Ryan Lohre1, Sarah Koljaka1, Nicholas Wiley1
1Department of Orthopaedic Surgery, Harvard Medical School, Massachusetts General Hospital, MGH Scapula Program, Boston, MA, USA.
JSES Reviews, Reports, and Techniques
|January 21, 2026
Summary
Endoscopic long thoracic nerve (LTN) decompression effectively alleviates debilitating periscapular pain and improves shoulder range of motion. This minimally invasive procedure offers significant pain relief with few complications, enhancing patient outcomes.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Pain Management
Background:
- Axillary and inferior periscapular pain, often linked to scapulothoracic abnormalities like nerve winging, can be incapacitating.
- The long thoracic nerve (LTN) is implicated in these conditions, making its decompression a potential therapeutic target.
Purpose of the Study:
- To evaluate the efficacy of endoscopic thoracic long thoracic nerve (LTN) decompression in treating persistent axillary and inferior periscapular border pain.
- To assess the impact of the procedure on patient-reported outcomes and shoulder joint mobility.
Main Methods:
- A retrospective review of 31 patients who underwent endoscopic LTN decompression for periscapular pain between 2020 and 2024.
- Data collected included patient demographics, pre- and postoperative outcome measures (VAS, SSV, PROMIS, DASH), and range of motion.
- Concomitant procedures such as pectoralis minor release and brachial plexus neurolysis were noted.
Main Results:
- Significant improvements were observed in Visual Analog Scale (VAS) pain scores (7.7 to 2.7) and Subjective Shoulder Value (SSV) (38.0% to 85.6%).
- Forward elevation, abduction, and external rotation ranges of motion significantly improved post-surgery.
- Complications were minimal (12.9%), with no identifiable patient or surgical factors predicting them.
Conclusions:
- Endoscopic decompression of the thoracic LTN is an effective treatment for periscapular pain, improving both pain levels and shoulder function.
- The procedure demonstrates a favorable safety profile with low complication rates.
- Further research is warranted to ascertain long-term efficacy and outcomes.
Keywords:
Long thoracic nerveLong thoracic nerve decompressionLong thoracic nerve releasePeriscapular painScapular wingingScapulothoracic abnormal motionMore Related Videos
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