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Thoracic outlet syndrome.

W W Woods

    The Western Journal of Medicine
    |January 1, 1978
    PubMed
    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.

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    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.

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