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Summary
Thoracic outlet syndrome (TOS) frequently follows soft tissue cervical injuries, often misdiagnosed. While conservative treatments help many, surgical decompression is necessary for persistent cases, effectively treating neck-arm symptoms and vertebrobasilar issues.
Area of Science:
- Orthopedics
- Neurology
- Traumatology
Background:
- Soft tissue cervical injuries are common post-trauma issues.
- Thoracic outlet syndrome (TOS) development after these injuries is underrecognized.
- TOS can manifest as neck-shoulder-arm syndrome and vertebrobasilar artery syndrome.
Purpose of the Study:
- To determine the incidence of TOS in soft tissue cervical injuries.
- To evaluate the effectiveness of conservative and surgical treatments for TOS.
- To identify common misdiagnoses associated with TOS.
Main Methods:
- Retrospective analysis of 1,958 patients with soft tissue cervical injuries.
- Diagnosis of TOS based on clinical presentation.
- Assessment of treatment outcomes for conservative and surgical interventions.
- Long-term follow-up of 90 patients.
Main Results:
- 23% of patients (459/1958) were diagnosed with TOS.
- 41% of TOS patients (185/459) did not respond to conservative treatment.
- Surgical decompression was required for 185 patients.
- 72% of surgical patients had co-existing, unrecognized vertebrobasilar artery syndrome.
- Common misdiagnoses included cervical disc syndrome and cervical strain (42% each).
- Long-term follow-up (7 years) showed good results in 75% of surgical patients.
Conclusions:
- TOS is a frequent complication of soft tissue cervical injuries.
- Surgical intervention provides effective relief for refractory TOS, including associated vertebrobasilar symptoms.
- Accurate diagnosis is crucial, as TOS is often misdiagnosed as cervical disc syndrome or strain.