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Related Experiment Videos

Upper plexus thoracic outlet syndrome: optimal therapy

H C Urschel1, M A Razzuk

  • 1Division of Thoracic and Cardiovascular Surgery, The University of Texas Southwestern Medical School and Baylor University Medical Center, Dallas, USA.

The Annals of Thoracic Surgery
|April 1, 1997
PubMed
Summary

Transaxillary first rib resection effectively treats upper plexus thoracic outlet syndrome, comparable to lower plexus cases. This single approach eliminates the need for combined or supraclavicular procedures for median nerve compression.

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Area of Science:

  • Neurosurgery
  • Vascular Surgery
  • Orthopedic Surgery

Background:

  • Historically, upper plexus thoracic outlet syndrome (TOS) required combined supraclavicular and transaxillary approaches.
  • Anatomical understanding now indicates muscles compressing the upper plexus attach to the first rib.

Purpose of the Study:

  • To evaluate the efficacy of transaxillary first rib resection for upper plexus TOS.
  • To compare outcomes of transaxillary resection for upper versus lower plexus TOS.

Main Methods:

  • Retrospective analysis of 2,210 thoracic outlet syndrome operations.
  • Categorization of patients based on nerve involvement: upper plexus (median nerve) only, lower plexus (ulnar nerve) only, or both.

Main Results:

Related Experiment Videos

  • Transaxillary first rib resection demonstrated comparable symptom relief for upper plexus (median nerve) and lower plexus (ulnar nerve) TOS.
  • No significant differences in treatment outcomes were observed between median and ulnar nerve compression groups.

Conclusions:

  • Transaxillary first rib resection alone is sufficient for treating upper plexus (median nerve) TOS.
  • The data challenge the necessity of supraclavicular or combined approaches for upper plexus TOS.