Thoracic outlet syndrome: evaluation of clinical features and long-term outcomes after escalenotomy

Abstract

Background

Thoracic outlet syndrome (TOS) is a very complicated and diverse pathology including a range of symptoms related to the upper limb, neck, head, and other symptoms. This study was aimed to evaluate the long-term results of anterior scalenotomy in patients with TOS.

Methods

We examined patients that were operated on 2007–2011. The rate of symptoms was evaluated from medical records. Changes in pain, tactile sensation, strength of a handgrip, muscle wasting and patient's satisfaction were evaluated postoperatively.

Results

Seventy-seven patients returned to follow-up evaluation (23 patients were treated for bilateral plexopathy). The mean follow-up was 50.3 months. Preoperative complaints (%) were as follows: upper extremity pain (93.0), numbness/paresthesia (93.7), decrease in hand strength (90.0) and headaches (53.8). Postoperatively, upper extremity pain disappeared in 81.7, numbness in 86.7 and headaches in 42.9 % of cases. Hand strength increased from 16.1 to 19.68 kg on average. Patients' satisfaction with the results was evaluated as (%) follows: excellent (50.0), good (33.0), fair (15.0) and poor (2.0).

Conclusions

Anterior scalenotomy is an effective operative method to treat TOS.

Level of Evidence: Level IV, therapeutic study.

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