[Pathogenesis of thoracic outlet syndrome: diagnosis with neurography of the brachial plexus].
From 1985 to 1992, the brachial plexus in 130 cases with thoracic outlet syndrome (TOS) was examined by neurography. We found evidence of stretching in patients with severe symptoms who were examined with their arm at their side. We studied the relationship between the evidence we found and the clinical symptoms and signs, to investigate the pathogenesis of TOS. The compression and stretching of the brachial plexus were evaluated visually. The TOS cases were classified into four types: (I) Compression only, (II) Compression > Stretching, (III) Compression < Stretching, and (IV) Stretching only. We confirmed that there were characteristic clinical features for each type of TOS. From these results, both compression and stretching of the brachial plexus were suggested pathogenetic factors of TOS. Conservative treatment using a scapular band was effective for the stretching types III and IV, while surgical treatment was indicated for the compression types I and II.
Kataoka
Y
Y
Department of Orthopedic Surgery, Kumamoto University School of Medicine.
D000293:Adolescent; D000328:Adult; D001917:Brachial Plexus / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D011859:Radiography; D013901:Thoracic Outlet Syndrome / Q000145:classification / Q000000981:diagnostic imaging* / Q000209:etiology*