The Treatment of Thoracic Outlet Syndrome
Journal of the Korean Microsurgical Society
; : 102-107, 2011.
Article
em Ko
| WPRIM
| ID: wpr-724763
Biblioteca responsável:
WPRO
ABSTRACT
PURPOSE:
As clinical manifestations of thoracic outlet syndrome are vague pain or symptoms in upper extremity, the diagnosis of the disease is delayed or misdiagnosed as cervical HNP, shoulder pathologies, or peripheral neuropathies. In that reason, many patients spend time for unnecessary or ineffective treatments. We report the results of our thoracic outlet syndrome cases, which were treated by conservative care or surgical treatment. MATERIALS &METHODS:
Twenty five cases, diagnosed as thoracic outlet syndrome since 1999, were reviewed retrospectively. Physical examinations including Adson's and reverse Adson's test, hyperabduction test, costoclavicular maneuver, and Roo's test, plain radiography of shoulder and cervical spine, MRI of neck or brachial plexus, and EMG were checked. If subjective symptoms were not improved after conservative treatments over three months, surgical treatment were performed. Nine patients were performed operative treatment and the others had conservative treatment in outpatient clinic. Postoperative improvement of symptoms and the follow up period, and the results of conservative care were reviewed.RESULTS:
Among five physical examinations, mean 1.75 tests were positive, and EMG has little diagnostic value. MRI were performed in twenty cases and compression of brachial plexus were found in 6 cases (30%). Ten patients out of 16 conservative treatment group had excellent improvement of symptoms, and 5 had good results. Eight patients out of 9 operative treatment group had excellent improvement with mean 5.1 months of follow-up period.CONCLUSION:
Diagnosis of thoracic outlet syndrome is difficult due to bizarre and vague symptoms. However if the diagnosis is suspected by careful physical examinations, radiologic studies, or nerve conduction studies, conservative care should be done as initial treatment and at least after three months, reassess the patient's condition. If the results of conservative treatment is not satisfactory and still the thoracic outlet syndrome is suspected, surgical treatment should be considered. Conservative treatment and operative technique are the valuable for the treatment of this disease.Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Exame Físico
/
Ombro
/
Coluna Vertebral
/
Síndrome do Desfiladeiro Torácico
/
Plexo Braquial
/
Estudos Retrospectivos
/
Seguimentos
/
Doenças do Sistema Nervoso Periférico
/
Extremidade Superior
/
Instituições de Assistência Ambulatorial
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
Ko
Revista:
Journal of the Korean Microsurgical Society
Ano de publicação:
2011
Tipo de documento:
Article