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Thoracic outlet syndrome: a current overview

S E Mackinnon1, G A Patterson, C B Novak

  • 1Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.

Seminars in Thoracic and Cardiovascular Surgery
|April 1, 1996
PubMed
Summary
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Thoracic outlet syndrome often involves multiple issues, making surgery a rare necessity. Conservative management is typically preferred for workplace-related symptoms affecting the neck, shoulder, and back.

Area of Science:

  • Neurology
  • Orthopedic Surgery
  • Pain Management

Background:

  • Thoracic outlet syndrome (TOS) surgery carries a controversial reputation.
  • Workplace-related TOS often presents with complex, multi-component symptomatology.
  • Symptoms include multilevel nerve compression and imbalances in neck, shoulder, and back musculature.

Purpose of the Study:

  • To emphasize the importance of conservative management for TOS.
  • To highlight the complexity of TOS evaluation and treatment.
  • To underscore the technical demands and required expertise for TOS surgery.

Main Methods:

  • Comprehensive evaluation of patients presenting with TOS symptoms.
  • Identification of contributing factors such as multilevel nerve compression and muscle imbalance.

Related Experiment Videos

  • Focus on conservative management strategies for neck, shoulder, and back issues.

    • Main Results:

    • Conservative management is often sufficient, rendering surgery a rare event for most workplace-related TOS cases.
    • Multilevel nerve compression and muscle imbalance are key diagnostic considerations.
    • Surgical decompression of the brachial plexus is technically demanding.

    Conclusions:

    • Conservative management should be prioritized for TOS, particularly in workplace-related cases.
    • Surgical intervention for TOS is reserved for complex cases and requires specialized surgical expertise.
    • A thorough understanding of neuromuscular physiology and chronic pain is crucial for effective TOS patient evaluation.