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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

1
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.
2
Servicio de Diagnóstico por Imágenes, Instituto de Neurociencias, Universidad Favaloro, Buenos Aires, Argentina.
3
Servicio de Neurocirugía, Hospital Padilla, Tucumán, Argentina.
4
Servicio de Neurocirugía, Hospital Regional Universitario Carlos Haya, Málaga, España.
5
Servicio de Neurología, Instituto de Neurociencias, Universidad Favaloro, Buenos Aires, Argentina.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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%).

CONCLUSIONS:

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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