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Surg Neurol Int. 2014 Aug 4;5(Suppl 5):S247-55. doi: 10.4103/2152-7806.137950. eCollection 2014.

[Thoracic Outlet Syndrome: is it always a surgical condition? Analysis of a series of 31 cases operated by the supraclavicular route].

[Article in Spanish]

Author information

Programa de Cirugía de Nervios Periféricos y Plexos, Servicio de Neurocirugía, Hospital de Clínicas, Universidad de Buenos Aires, Buneos Aires, Argentina ; Servicio de Neurocirugía, Hospital Británico de Buenos Aires, Buneos Aires, Argentina ; Servicio de Neurocirugía, Instituto de Neurociencias, Universidad Favaloro, Buenos AIres, Argentina.
Servicio de Diagnóstico por Imágenes, Instituto de Neurociencias, Universidad Favaloro, Buenos Aires, Argentina.
Servicio de Neurocirugía, Hospital Padilla, Tucumán, Argentina.
Servicio de Neurocirugía, Hospital Regional Universitario Carlos Haya, Málaga, España.
Servicio de Neurología, Instituto de Neurociencias, Universidad Favaloro, Buenos Aires, Argentina.



Thoracic Outlet Syndrome is a compression of the brachial plexus that remains highly controversial. Classification in True or Neurogenic Outlet (TTO) and Disputed or Non-neurogenic Outlet (DTO) is becoming very popular. The former is characterized by a muscular atrophy of the intrinsic muscles of the hand, while the latter has only sensitive symptoms. The purpose of this article is to analyze the results obtained in a series of 31 patients.


All patients with diagnosis of Thoracic Outlet operated between January 2003 and December 2012 with a minimum follow-up of six months where included. Age, sex, symptoms, classification, preoperative studies results, complications and recurrences were analyzed.


31 surgeries performed in 30 patients, 9 with TTO (8 women, mean age 24.3 years) and 21 with DTO (18 women, mean age 37.4 years, 1 recurrence) were included. Ninety percent of patients presented neurophysiological and 66.6% imagenological preoperative disturbances. All TTO and only 36.7% of DTO showed clear pathological findings during surgical exploration. A high percentage (87,5% sensitive and 77.7% motor) of TTO ameliorated after surgical decompression. Only 45.5% of DTO showed permanent positive changes, 13.6% temporary, 36.6% no changes, and 4.5%(one case) showed deterioration after decompresive surgery. Complications after surgery were more frequent –but temporary- in TTO cases (33.3%), than in DTO (13.6%).


TTO showed a favorable outcome after surgery. DTO showed a worst –but still positive- postoperative result if patients are selected properly. These data are in concordance with other recent reports.

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