Neurogenic thoracic outlet syndrome is caused by a neurologic compression of the brachial plexus before it reaches the arm. Three anatomic areas are common locations for such an entrapment because of their congenital and/or acquired tightness: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space. Because the compression level usually remains unknown, the treatment is still controversial and most teams focus on only one potential site. We propose an all-endoscopic technique of complete brachial plexus neurolysis that can be divided into three parts, one for each entrapment area. First, with a subacromial approach, the suprascapular nerve is released distally from the transverse ligament and then followed up to the upper trunk. Once the upper trunk is located, the middle and lower trunks are dissected in the interscalene triangle. Then, by use of an infraclavicular approach, the brachial plexus is released from the costoclavicular space by detaching the subclavian muscle from the clavicle. Finally, the pectoralis minor is released from the coracoid so that the brachial plexus is distally freed. This technique seems to be safe and reproducible, but expert knowledge of the neurovascular anatomy and advanced endoscopic skills are required.

CoCr and Ti rods both provide significant and stable frontal correction in AIS treated with posteromedial translation technique using hybrid constructs. However, CoCr might be considered to emphasize sagittal correction in hypokyphotic patients.

No abstract

Therapeutic, Level IV-Retrospective Cases Series.

IV: Therapeutic study-cases series.

Therapeutic type IV-Retrospective case series.

IV - retrospective case series.

Due to recent progress in shoulder arthroscopy, all-endoscopic brachial plexus (BP) dissection has progressively become a standardized procedure. Based on previously described techniques, we present an additional neurological procedure that may be performed all-endoscopically, that is, the excision of an infraclavicular BP schwannoma. Starting from a standard shoulder arthroscopy with posterior and lateral portals, additional anterior and medial portals are progressively opened outside the joint under endoscopic control to access the BP. At first, dissection of the subcoracoid space allows the identification of the posterior and lateral cords, along with the axillary artery. Then, by performing a pectoralis minor tenotomy, the medial cord and axillary vein are exposed, giving access to the whole infraclavicular plexus. Intraneural dissection is performed using arthroscopic tools such as a long beaver blade, a grasper, and a smooth dissector to progressively extract the encapsulated tumor from the nerve without any damage. Using a standardized technique, endoscopy may be an advantageous tool in selected cases of BP benign peripheral nerve sheath tumors.