Thoracic outlet syndrome : five years experience

Abstract EN

Background and Objectives Thoracic outlet syndrome is mainly neurogenic presenting with pain, parasthesia, and weakness of upper limb and uncommonly with vascular symptoms (venous or arterial), the objective of the study is to evaluate patient with thoracic outlet syndrome from clinical, radiological and electrophysiological point of view with its correlation with operative finding and outcome.

Methods This prospective study included 147 patients (132 females and 15 males) presented with signs and symptoms of thoracic outlet syndrome, their data collected including age, gender, symptoms, clinical examination sings, provocative test results, radiological findings, electrophysiological, surgical findings and procedures, with postoperative clinical, radiological and electrophysiological assessment and follow up, patients data were collected from Azadi Teaching Hospital and Duhok Private Hospital (Duhok City), from January, 2009 – January, 2013.

Results Among 147 patients, females affected most commonly (90%), and pain was main presenting symptom (100%), cervical rib found in 61 (41.5%) patients, 3 minutes stress test was positive in 93.2% of cases.

Neurophysiologic examination were suggestive of TOS in 80.3%, conservative treatment was effective in 79% of cases ; however operation had been done for 31 (21%) patients, where complete relieve obtained in 93.5% of operated patients, no major morbidity or mortality has been recorded.

Conclusions Diagnosis is a collection of symptoms, signs and investigations.

Surgery still indicated in many cases with excellent outcomes without permanent disability