Document Detail

Long-term outcome analysis of the supraclavicular surgical release for the treatment of thoracic outlet syndrome.
MedLine Citation:
PMID:  20495423     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This is a long-term outcome analysis of patients who underwent surgical treatment with a supraclavicular release for thoracic outlet syndrome (TOS).
METHODS: All patients undergoing supraclavicular release between January 1, 1987, and December 31, 2000, at University Hospital, Inselspital, Bern, Switzerland, were included in this study. Of 29 treated patients, 22 patients (24 TOS) underwent both long-term clinical follow-up (median 12.5 years, standard deviation 3.5 years, range 5-18 years) and short-term clinical follow-up (median 6.6 months, standard deviation 4.5 years, range 3-12 months).
RESULTS: Eleven patients (12 TOS operations) were classified as having a neurogenic cause of TOS, whereas the other 11 (12 TOS operations) were classified as having disputed TOS. Patient data, including various outcome parameters, such as pain and disabilities of arm, shoulder, and hand scores, were evaluated pre- and postoperatively and at long-term follow-up by an independent examiner. The surgical supraclavicular technique is described in detail. In 21 of 24 surgical release procedures, the first rib was resected. There was a marked permanent long-term postoperative reduction of symptoms in both neurogenic and disputed TOS groups. The pain and disabilities of arm, shoulder, and hand scores improved significantly after surgery, regardless of the etiology, in the short- and long-term postoperative observation periods. There were no patients with workers' compensation or litigation issues.
CONCLUSION: This study demonstrates the successful, constant long-term relief of symptoms in carefully selected patients with neurogenic and disputed TOS using the described surgical supraclavicular release technique.
Esther Vögelin; Lorenz Haldemann; Mihai A Constantinescu; Ariane Gerber; Ulrich Büchler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  66     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-24     Completed Date:  2010-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1085-91; discussion 1091-2     Citation Subset:  IM    
Department of Plastic, Reconstructive and Hand Surgery, University Hospital, Inselspital, University of Bern, Bern, Switzerland.
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MeSH Terms
Arm / blood supply,  innervation
Axillary Artery / anatomy & histology,  pathology,  surgery
Brachial Plexus Neuropathies / pathology,  physiopathology,  surgery
Middle Aged
Neurosurgical Procedures / methods*
Retrospective Studies
Ribs / anatomy & histology,  pathology,  surgery*
Thoracic Outlet Syndrome / pathology,  physiopathology,  surgery*
Thoracic Surgical Procedures / methods*
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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