Recurrent neurogenic thoracic outlet syndrome

Ambrad–Chalela, Esteban; Thomas, George I.; Johansen, Kaj

doi:10.1016/j.amjsurg.2003.12.050

Cited by 100 publications

(44 citation statements)

References 20 publications

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“…This case report offers a uniform approach that is both effective and reduces the risk of symptom exacerbation due to aggressive intervention resulting in further damage. A retrospective review of TOS (n = 500) by AmbradChalela et al (8) demonstrated that 17 cases with recurrent symptoms were offered physical therapy (massage, mobilization, ultrasound, and scalene stretching) with results showing a lack of improvement. The methodology description for this study was limited and, therefore, difficult to assess; however, it may provide support for the possibility that the massage aspects of the treatment plan produced a positive outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical interventions are the treatment of choice in severe cases, in most literature (8) . Studies of conservative treatment are fewer and rarely cover the details of the interventions employed (8,9) . This massagefocused case study was designed to reduce the gap in evidence-based research for conservative TOS treatments.…”

Section: Mary Lillias Wakefield Bhs Mtmentioning

confidence: 99%

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Case Report: The Effects of Massage Therapy on a Woman with Thoracic Outlet Syndrome

Wakefield

2014

IJTMB

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Introduction: Thoracic outlet syndrome (TOS) refers to a group of conditions resulting from compression of the neurovascular structures of the thoracic outlet. The parameters for physical therapy include myofascial release (MFR), neuromuscular therapy (NMT), muscle strengthening, and stretching. This case study examined the effects of neuromuscular therapy, massage, and other manual therapies on a 56-year-old female presenting with bilateral numbness over the forearms and hands on waking. Numbness occurred most days, progressing to "dead rubbery" forearms and hands once or twice a month.Methods: The treatment plan was implemented over eight weeks and consisted of six, 50-minute bodywork sessions. Several nonbodywork strategies were also employed to address potential contributing factors to the TOS symptomology experienced by the client. Objective measurements included posture analysis (PA), range of movement (ROM), and Roos and Adson's tests. The Measure Your Own Medical Outcome Profile (MYMOP2), a client-generated measure of clinical outcome, was used to measure clinical change.Results: MYMOP2 overall profile score results demonstrated an improvement of 2.25 from pretreatment to post-treatment measurement. Clinically meaningful change was measured by the individual and was indicative of substantial symptom improvement where a score change of over one was considered as meaningful.Conclusions: A course of massage was effective for numbness symptoms in an individual with TOS, and results lasted over a year without additional treatments. Further research is needed to fully understand the effects of massage for TOS symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Mary Lillias Wakefield Bhs Mtmentioning

confidence: 99%

Case Report: The Effects of Massage Therapy on a Woman with Thoracic Outlet Syndrome

Wakefield

2014

IJTMB

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“…Symptoms of the syndrome may be vascular, neurological or combined symptoms involving both (1,14,25). Although the syndrome was initially named after compressive aetiologies such as scalenus anticus, costoclavicular, hyperabduction, cervical rib and first thoracic rib, Peet used the term "Thoracic Outlet Syndrome" to define the compression of neurovascular structures at the thoracic outlet (15).…”

Section: Introductionmentioning

confidence: 99%

Supraclavicular surgical approach for thoracic outlet syndrome: 10 years of experience

Dalbayrak¹,

Yaman²,

Yılmaz³

et al. 2013

Turkish Neurosurgery

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AIm: Symptoms of thoracic outlet syndrome (TOS) may be vascular, neurological or combined symptoms involving both. Treatment of TOS is generally conservative. Surgical treatment is required when radiological results indicate anatomical abnormality. This study aims to present the surgical outcomes of TOS patients treated with supraclavicular approach via microsurgery. mATERIAl and mEThods: 41 patients with thoracic outlet syndrome were rewieved retrospectively. The pain was determined using both on visual analogue scale (VAS) and Oswestry score both in the preoperative and postoperative period. All patients underwent electromyography including brachial plexus, ulnar and median nerves. Computed Tomography (CT) angiographic examination was applied dynamically with required manoeuvres.REsulTs: Post-op VAS scores were recorded as 0.8 for the arm, 0.6 for the shoulder and 0.5 for the neck, while pre-op VAS scores were 6.3 for the arm, 6.0 for the shoulder and 5.2 for the neck. Post-op Oswestry disability index (ODI) average was found as 14,2, while this figure was 67,4 during the pre-operative period.CoNClusIoN: Accurate patient selection is imperative for increasing the success of TOS surgery. Microscopic TOS surgery yields satisfactory results with smaller incision, safer surgery and a lower rate of complication.KEywoRds: Thoracic outlet syndrome, Supraclavicular approach, Surgery ÖZ AmAÇ: Torasik çıkış sendromu (TÇS) vasküler, nörolojik ya da her iki yapıya bası sonucu ortaya çıkabilir. TÇS tedavisi genellikle konservatiftir. Radyolojik olarak tespit edilen anomali durumunda cerrahi tedavi gereklidir. Bu çalışmanın amacı, supraklaviküler yol ve mikroşirürjkal teknikle ameliyat edilen TÇS tanılı hastaların cerrahi sonuçlarını bildirmektir. yÖNTEm ve GEREÇlER: TÇS nedeni ile opere edilen 41 hasta geriye dönük olarak incelendi. Hastaların klinik durumları görsel ağrı skoru (VAS) ve Oswestry skorlaması (ODI) ile cerrahi öncesi ve sonrası değerlendirildi. Hastaların tamamına cerrahi öncesi brakial pleksus, ulnar ve median sinirleri kapsayacak şekilde elektromyografik inceleme ve gerekli manevralar yapılarak dinamik bilgisayarlı tomografik anjiografileri (BTA) yapıldı.BulGulAR: Cerrahi öncesi kol, omuz ve boyun ağrısı VAS değerleri sırasıyla 6,3; 6,0; 5,2 iken cerrahi sonrası kol, omuz ve boyun ağrısı VAS değerleri sırasıyla 0,8; 0,5; 0,5 olarak tespit edildi. ODI cerrahi öncesi ortalama 67.4 iken bu değer cerrahi sonrası 14.2'e indi. soNuÇ: TÇS için doğru hasta seçimi cerrahi başarı şansını artıracaktır. Mikroskop eşliğinde yapılan TÇS daha küçük açılım, daha emniyetli cerrahi ve daha az komplikasyon oranı ile ile yüz güldürücü sonuçlar vermektedir.ANAhTAR sÖZCÜKlER: Torasik çıkış sendromu, Supraklaviküler yaklaşım, Cerrahi

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“…9 The anesthetic injection allows the first rib to descend by relaxing the scalene muscle and thereby decompressing the BP. 6,[9][10][11] The anterior scalene block has been the most helpful test to confirm the diagnosis of NTOS 5,6,[11][12][13][14][15] and to predict the response to surgery, because it may mimic the results of first-rib resection and anterior scalenectomy. 6,[10][11][12]14,16 However, to be predictive, the injection should avoid anesthesia of the BP and sympathetic chain, and the patient should be both medically and psychologically stable.…”

mentioning

confidence: 99%

“…6,[9][10][11] The anterior scalene block has been the most helpful test to confirm the diagnosis of NTOS 5,6,[11][12][13][14][15] and to predict the response to surgery, because it may mimic the results of first-rib resection and anterior scalenectomy. 6,[10][11][12]14,16 However, to be predictive, the injection should avoid anesthesia of the BP and sympathetic chain, and the patient should be both medically and psychologically stable. 13 Different methods have been used to guide the scalene injection, including the use of anatomic landmarks, 13,17 EMG, 12 sonography, 11 combinations of EMG and sonography, 18 EMG and fluoroscopy, 18 and CT most recently.…”

mentioning

confidence: 99%

CT-Guided Injection of the Anterior and Middle Scalene Muscles: Technique and Complications

Mashayekh

Christo²,

Yousem³

et al. 2011

AJNR Am J Neuroradiol

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Recurrent neurogenic thoracic outlet syndrome

Cited by 100 publications

References 20 publications

Case Report: The Effects of Massage Therapy on a Woman with Thoracic Outlet Syndrome

Case Report: The Effects of Massage Therapy on a Woman with Thoracic Outlet Syndrome

Supraclavicular surgical approach for thoracic outlet syndrome: 10 years of experience

CT-Guided Injection of the Anterior and Middle Scalene Muscles: Technique and Complications

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