Thoracic Outlet Syndrome in the Pediatric Population: Case Series

Vu, Anthony T.; Patel, Parit A.; Elhadi, Haithem; Schwentker, Ann; Yakuboff, Kevin P.

doi:10.1016/j.jhsa.2013.11.029

Cited by 17 publications

(2 citation statements)

References 15 publications

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“…In pediatric patients, it is more common for a bony anomaly to exist in addition to these bands. 17,19 In our series of adolescents, the first rib was left intact in 66.7% of our patients with long-term follow-up with no difference in outcome measures, suggesting that patients who present in adolescence more closely mimic the pathology of adults than younger children. 6,17-19…”

Section: Discussionmentioning

confidence: 66%

Intermediate and Long-term Outcomes Following Surgical Decompression of Neurogenic Thoracic Outlet Syndrome in an Adolescent Patient Population

Ransom

Minton

Young

et al. 2020

Hand (New York, N,Y.)

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Background: Although the diagnosis of thoracic outlet syndrome (TOS) is often missed, outcomes from surgical intervention significantly improve patient satisfaction. This article seeks to highlight patient characteristics, intraoperative findings, and both short and long-term outcomes of thoracic outlet decompression in the adolescent population. Methods: A retrospective chart review of patients between the ages of 13 and 21 years with a clinical diagnosis of neurogenic thoracic outlet syndrome (NTOS) who were treated surgically between 2000 and 2015 was performed. Data points including preoperative patient characteristics and intraoperative findings were collected. In addition, patient-reported outcome scores, including Visual Analog Scale (VAS), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, Cervical Brachial Symptom Questionnaire (CBSQ), and NTOS index, were obtained for a cohort of patients with follow-up ranging from 2 to 15 years. Results: The study population consisted of 54 patients involving 61 extremities. The most common procedures included neurolysis of the supraclavicular brachial plexus (60, 98.4%), anterior scalenectomy (59, 96.7%), and middle scalenectomy (54, 88.5%). First rib resection (FRR) was performed in 28 patients (45.9%). Long-term outcomes were collected for 24 (44%) of 54 patients with an average follow-up of 69.5 months (range, 24-180 months). The average VAS improved from 7.5 preoperatively to 1.8 postoperatively. The average SANE increased from 28.9 preoperatively to 85.4 postoperatively. The average postoperative scores were 11.4 for the QuickDASH, 27.4 for the CBSQ, and 17.2 for the NTOS index. Subgroup analysis of patients having FRR (28, 45.9%) demonstrated no difference in clinical outcome measures compared with patients who did not have FRR. Conclusion: Surgical treatment of NTOS in adolescent patients has favorable intermediate and long-term outcomes.

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Section: Discussionmentioning

confidence: 66%

Intermediate and Long-term Outcomes Following Surgical Decompression of Neurogenic Thoracic Outlet Syndrome in an Adolescent Patient Population

Ransom

Minton

Young

et al. 2020

Hand (New York, N,Y.)

View full text Add to dashboard Cite

show abstract

“…However, to date, no clear evidence on the success rate of such treatment in aTOS children with stroke has been provided. Reported pediatric series [ 3 , 13 , 17 , 19 , 20 ] contain only single aTOS cases younger than 10 years. Although surgery seems effective for distal (forearm, hand) complaints, the risks and benefits of vascular reconstruction of the potential SA aneurysm are still a matter of debate.…”

Section: Discussionmentioning

confidence: 99%