Differences in quality of life outcomes after paraclavicular decompression for thoracic outlet syndrome

Rstum, Zain Al; Tanaka, Akiko; Sandhu, Harleen K.; Miller, Charles C.; Saqib, Naveed U.; Besho, Joseph M.; Charlton-Ouw, Kristofer M.; Azizzadeh, Ali

doi:10.1016/j.jvs.2019.12.037

Cited by 6 publications

(12 citation statements)

References 9 publications

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“…Mental stress is very rarely mentioned in the TOS literature, however. We found only one mention concerning NTOS: "Patients with NTOS reported significantly lower aggregate mental health QoL than patients with vascular-only TOS" (Al Rstum et al 2020). Similarly, TOSI question 12, on difficulty in working overall, correlates quite poorly with CBSQ and QDASH; CBSQ does not measure work capacity at all, and QDASH measures it by one question.…”

Section: Discussionmentioning

confidence: 92%

Convergent Validity of Thoracic Outlet Syndrome Index (TOSI)

Ruopsa

Vastamäki

Ristolainen

et al. 2022

Physical Activity and Health

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No disease-specific evaluation score for thoracic outlet syndrome (TOS) patients was available prior to the presentation of the Thoracic Outlet Syndrome Index (TOSI) score. Our aim was to assess the convergent validity of the TOSI when compared with the short form of Disabilities of the Arm, Shoulder and Hand (QDASH), the Cervical Brachial Symptom Questionnaire (CBSQ), and pain numeric rating scale (painNRS) after supraclavicular rib-sparing decompression for neurogenic TOS. The TOSI takes into account five domains important to TOS patients with 15 questions, whereas QDASH considers only four domains, and CBSQ and painNRS each has only one domain. Our 67 TOS patients, mean age 36.5 years at surgery, were evaluated clinically for a mean 13.2 years after rib-sparing surgery. They completed the QDASH, the CBSQ, the pain NRS, and the TOSI questionnaires. Correlations between TOSI total score and QDASH, CBSQ total scores, and the painNRS were strong: 0.67 for TOSI vs. QDASH; 0.75 for TOSI vs. CBSQ; and 0.65 for TOSI vs. painNRS. The TOSI demonstrated good convergent validity. It may thus become a valuable addition among tools for assessing the quality of life and functioning of those with neurogenic thoracic outlet syndrome as well as for improving comparability of results across varying settings in this field.

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Section: Discussionmentioning

confidence: 92%

Convergent Validity of Thoracic Outlet Syndrome Index (TOSI)

Ruopsa

Vastamäki

Ristolainen

et al. 2022

Physical Activity and Health

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“…2008;33:1518-1524. nTOS reported significantly lower mental health Quality of Life scores than patients with vTOS preoperatively and throughout follow-up. 54 As surgical approaches for the management of TOS involve decompression surrounding delicate, important neurovascular structures, complications can be severe and even life-threatening. Injury to the subclavian vein or artery, brachial plexus, thoracic duct and long thoracic, intercostobrachial, recurrent laryngeal, and phrenic nerves have been reported.…”

Section: Discussionmentioning

confidence: 99%

Current Concepts in the Management of Neurogenic Thoracic Outlet Syndrome: A Review

Khabyeh-Hasbani

Connors

Buksbaum

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Thoracic outlet syndrome is a constellation of signs and symptoms due to compression of the neurovascular bundle of the upper limb. In particular, neurogenic thoracic outlet syndrome can present with a wide constellation of clinical manifestations ranging from pain to paresthesia of the upper extremity, resulting in a challenge to correctly diagnose this syndrome. Treatment options range from nonoperative treatment, such as rehabilitation and physical therapy, to surgical correction, such as decompression of the neurovascular bundle. Methods: Following a systematic review of the literature, we describe the need for a thorough patient history, physical examination, and radiologic images which have been reported to correctly diagnose neurogenic thoracic outlet syndrome. Additionally, we review the various surgical techniques recommended to treat this syndrome. Results: Postoperative functional outcomes have been shown to be more favorable in arterial and venous thoracic outlet syndrome (TOS) patients when compared with neurogenic TOS patients, likely due to the ability to completely remove the site of compression in cases of vascular TOS as compared with incomplete decompression in neurogenic TOS. Conclusions: In this review article, we provide an overview of the anatomy, etiology, diagnostic modalities, and current treatment options of correcting neurogenic TOS. Additionally, we offer a detailed step-by-step technique of the supraclavicular approach to the brachial plexus, a preferred approach for decompressing neurogenic TOS.

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“…Derkash's classification is a region-specific tool, as it assesses perceived disability in patients with arm, shoulder, and hand problems. These assessment schemes can well reflect the function of the upper limb and are used to categorize primary outcomes as “excellent” if there was no pain and a return to preoperative status, “good” if intermittent pain was well tolerated and there was the possibility of a return to the preoperative status, “fair” if intermittent or permanent pain was not well tolerated and a return to the preoperative status was difficult, or “poor” if symptoms had not improved or were aggravated ( 26 ). Peek et al ( 27 ) confirmed that Derkash's classification was an effective tool to evaluate the improvement of upper limb function because of its wide use in practice and the availability of the data.…”

Section: Discussionmentioning

confidence: 99%

Derkash's Classification and Vas Visual Analog Scale to Access the Long-Term Outcome of Neurothoracic Outlet Syndrome: A Meta-Analysis and Systematic Review

et al. 2022

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ObjectiveMany publications report outcomes of surgical treatment for neurothoracic outlet syndrome (NTOS); however, high-quality meta-analyses regarding objective evaluation system accessing the long-term outcome of NTOS are lacking. This meta-analysis summarizes and compares the outcomes of Derkosh's classification and vas visual analog scale of the supraclavicular neuroplastic of brachial plexus (SNBP) and trams auxiliary first rib resection (TFRR).MethodsThe Cochrane Library, PubMed, EMBASE, Allied and Complementary Medicine (AMED) were searched for papers published between January 1980 and February 2021, using the keywords “thoracic outlet syndrome,” “treatment, surgical.” Articles were eligible for inclusion if the following criteria were met studies describing outcomes of surgery for NTOS, published in English, human studies, and available in full text. The exclusion criteria were case reports (n < 10), reviews, abstracts, and studies lacking a control group or without evaluation for two types of surgery.ResultsWe included 10 studies with 1,255 cases, out of which 622 were in the SNBP group; and 633 were in the TFRR group. After surgery (≥12 months), Derkash's classification was improved in 425 cases with SNBP and 364 cases with TFRR. OR = 1.34 (95% CI: 0.94, 1.92), P = 0.03; vas visual analog scale was improved in 282 cases in the SNBP group and 214 cases in the TFRR group. OR = 1.08 (95% CI: 0.63, 1.85), P = 0.78.ConclusionThis meta-analysis shows that both SNBP and TFRR are effective for NTOS, but that SNBP is better than TFRR in improving Derkash's classification in the long term. Although patients treated with SNBP are more satisfactory, there is no significant difference in vas visual analog scale from TFRR.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42021254203, PROSPERO CRD42021254203.

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Differences in quality of life outcomes after paraclavicular decompression for thoracic outlet syndrome

Cited by 6 publications

References 9 publications

Convergent Validity of Thoracic Outlet Syndrome Index (TOSI)

Convergent Validity of Thoracic Outlet Syndrome Index (TOSI)

Current Concepts in the Management of Neurogenic Thoracic Outlet Syndrome: A Review

Derkash's Classification and Vas Visual Analog Scale to Access the Long-Term Outcome of Neurothoracic Outlet Syndrome: A Meta-Analysis and Systematic Review

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