[Neurogenic thoracic outlet syndrome. Long-term results of supraclavicular decompression].
OBJECTIVE
Neurogenic thoracic outlet syndrome (TOS) is one of the most controversial entrapment syndromes of the upper extremity. There are two different surgical approaches for its primary surgical treatment: supraclavicular decompression and transaxillary first rib resection. The aim of this study was to evaluate long-term results and surgical risks of the former.


METHODS
This retrospective long-term study examines a series of 50 supraclavicular decompressions in 45 patients. Follow-up was for at least 24 months. All patients were reexamined regularly in nonstandardized fashion. Finally, each patient underwent a telephone interview with a standardized questionnaire.


RESULTS
There was a significant deterioration of primary results during follow-up. About 30.0% of cases worsened within 24 months after operation. In the long run, about 80.0% of cases showed improvement of symptoms (26.0% excellent, 36.0% good, 18.0% moderate). The complication rate was 4.0%.


CONCLUSIONS
Due to secondary deterioration of treatment during follow-up, only long-term studies are suited for the examination of neurogenic TOS. Results after supraclavicular decompression are satisfactory, and the complication rate is low.
König
R W
RW
Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg. ralph.koenig@medizin.uni-ulm.de
Kretschmer
T
T
Börm
W
W
Hübner
F
F
Richter
H-P
HP
Antoniadis
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002968:Clavicle / Q000601:surgery*; D015897:Comorbidity; D019299:Decompression, Surgical / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013901:Thoracic Outlet Syndrome / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome