Transaxillary decompression of thoracic outlet syndrome patients presenting with cervical ribs

Abstract

This series of transaxillary cervical and first rib resections demonstrates excellent clinical outcomes with minimal morbidity. The presence of cervical ribs, a positive response to scalene muscle block, and abnormalities on electrodiagnostic testing are reliable indicators for surgery. A cervical rib in a patient with TOS suggests that there is excellent potential for improvement after first and cervical rib excision.

Tratamento de oclusão arterial em membro superior causada por costela cervical

“…The transaxillary surgical approach is a safe technique involving reduced manipulation of the brachial plexus, which can achieve a lower incidence of perioperative complications related to nerve damage. 4 , 7 It enables safe resection of cervical ribs and/or first ribs and is the approach most often used when concomitant resections are performed. 4 It also produces better esthetic results than the supraclavicular approach.…”

“…A abordagem cirúrgica transaxilar é uma técnica segura, que envolve menor manipulação do plexo braquial, podendo resultar em menor incidência de complicações perioperatórias associadas a lesões nervosas 4 , 7 . Também permite a ressecção de costelas cervicais e/ou primeiras costelas com segurança, sendo o acesso mais utilizado para resseções concomitantes 4 .…”

Torasik Outlet Sendromunda Cerrahi Tedavinin Etkinliği

“…In patients where the desired level of clinical relief could not be maintained despite physical therapy and medical treatment, surgical treatment can be recommended [4,5]. The purpose of surgical treatment is to completely remove the components that cause pressure [6], and they include the first rib and if present, cervical ribs and scalene muscles [7][8][9][10][11]. Patient's complaints almost completely disappear shortly after the surgical treatment performed without damaging the plexus brachialis, subclavian artery and subclavian vein, and as long as there are no leaking bleeding spots left in the operation area to cause future cohesions, the likelihood of recurrence of thoracic outlet syndrome in later periods is very low [6,12,13].…”

“…Taken together, the clinical experience of the physician in said cases is very important [1,2] In diagnosed patients, physical therapy methods accompanied by medical treatment are suggested as a first line treatment [3]. Medical treatment combined with physical therapy can lead to serious clinical relief, although it can never completely improve the current mechanical pressure [6]. In patients where the desired level of clinical relief could not be maintained despite physical therapy and medical treatment, surgical treatment can be recommended [4,5].…”

Neurogenic thoracic outlet syndrome: Bringing order to chaos

“…The current paper by Dr Gelabert (an editor of the second edition of the thoracic outlet syndrome textbook and coauthor of the reporting standards document cited before) and team 3 is one of the first reports to be published with the underlying purpose of these documents in mind. They describe 70 transaxillary cervical rib resections with excellent results.…”