Conduction block in thoracic outlet syndrome? The need for motor root stimulation

Matsumoto, Hideyuki; Ugawa, Yoshikazu

doi:10.1016/j.clinph.2015.04.064

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…The clinical manifestations and detailed history of our patient were strongly consistent with a diagnosis of TOS. However, the lack of a further diagnosis to ascertain the compression site resulted in a final diagnosis of nonspecific TOS, [23,24] but given the complexity of diagnosis and the overlapping of the patient's symptoms with those of other diseases, an accurate diagnosis of TOS can be a substantial challenge in practice. [25]…”

Section: Discussionmentioning

confidence: 99%

Thoracic outlet syndrome in a postoperative cervical spondylotic myelopathy patient

et al. 2019

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Rationale:Thoracic outlet syndrome (TOS) is a rare disease that presents with neurogenic and vascular symptoms similar to those of cervical spondylosis. However, making the diagnosis of TOS can be challenging due to a lack of standardized objective confirmatory tests.Patient concerns:A 66-year-old man presented with neck, supraclavicular, and right shoulder pain as well as numbness and weakness in the right arm after surgery to correct cervical spondylotic myelopathy (CSM).Diagnosis:Magnetic resonance imaging confirmed the diagnosis of CSM. He was diagnosed with TOS based on the manifestations and examination findings.Interventions:After surgery for CSM, nonoperative management was provided.Outcomes:The patient reported pain relief and improving sensation in the shoulder and supraclavicular region.Lessons:Based on this case and the reviewed literature, to optimize the diagnosis and treatment of CSM, clinicians should consider preoperative differential diagnosis to preliminarily exclude it.

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Section: Discussionmentioning

confidence: 99%

Thoracic outlet syndrome in a postoperative cervical spondylotic myelopathy patient

et al. 2019

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Intraoperative Electrophysiological Mapping in the Supraclavicular Approach for Thoracic Outlet Syndrome

et al. 2017

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Objective Methods for intraoperative electrophysiological mapping in thoracic outlet syndrome have not yet been established, despite the potential severity of surgical complications. A method for intraoperative electrophysiological mapping in the supraclavicular approach for thoracic outlet syndrome was developed. The purpose of the study was to verify the usefulness and validity of this method.Methods Twelve patients underwent surgery for thoracic outlet syndrome using this mapping method. The region of interest in an operative field was electrically stimulated, and evoked electromyography was recorded from the deltoid, biceps, triceps, and abductor pollicis brevis for the brachial plexus, the diaphragm for the phrenic nerve, and the serratus anterior for the long thoracic nerve. Cathodal stimulation was performed using a monopolar electrode. The stimulus rate was fixed at 3/s, and 0.2 ms biphasic square waves were applied. The stimulus current ranged from 0.5 mA to 2 mA. Whether this method enabled identification of important anatomical landmarks by referring to the evoked electromyography pattern was retrospectively investigated.Results In 10 of 12 cases, clinical improvement was obtained. In all cases, important landmarks related to the brachial plexus and phrenic nerve were identified with this mapping method. In 5 of 12 cases, the course of the long thoracic nerve in the middle scalene muscle was identified.Conclusion This monitoring method was useful for confirming the distribution of important nerves in the surgical field of thoracic outlet syndrome, and has great significance by enabling management of the anatomical variations seen in thoracic outlet syndrome.

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Conduction block in thoracic outlet syndrome? The need for motor root stimulation

Cited by 2 publications

References 13 publications

Thoracic outlet syndrome in a postoperative cervical spondylotic myelopathy patient

Thoracic outlet syndrome in a postoperative cervical spondylotic myelopathy patient

Intraoperative Electrophysiological Mapping in the Supraclavicular Approach for Thoracic Outlet Syndrome

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