title: [Thoracic Outlet Syndrome: is it always a surgical condition? Analysis of a series of 31 cases operated by the supraclavicular route].
abstract: Thoracic Outlet Syndrome is a compression of the brachial plexus that remains highly controversial. Classification in True or Neurogenic Outlet (TTO) and Disputed or Non-neurogenic Outlet (DTO) is becoming very popular. The former is characterized by a muscular atrophy of the intrinsic muscles of the hand, while the latter has only sensitive symptoms. The purpose of this article is to analyze the results obtained in a series of 31 patients.
  
  
  
  All patients with diagnosis of Thoracic Outlet operated between January 2003 and December 2012 with a minimum follow-up of six months where included. Age, sex, symptoms, classification, preoperative studies results, complications and recurrences were analyzed.
  
  
  
  31 surgeries performed in 30 patients, 9 with TTO (8 women, mean age 24.3 years) and 21 with DTO (18 women, mean age 37.4 years, 1 recurrence) were included. Ninety percent of patients presented neurophysiological and 66.6% imagenological preoperative disturbances. All TTO and only 36.7% of DTO showed clear pathological findings during surgical exploration. A high percentage (87,5% sensitive and 77.7% motor) of TTO ameliorated after surgical decompression. Only 45.5% of DTO showed permanent positive changes, 13.6% temporary, 36.6% no changes, and 4.5%(one case) showed deterioration after decompresive surgery. Complications after surgery were more frequent –but temporary- in TTO cases (33.3%), than in DTO (13.6%).
  
  
  
  TTO showed a favorable outcome after surgery. DTO showed a worst –but still positive- postoperative result if patients are selected properly. These data are in concordance with other recent reports.
authors.affiliation: Programa de Cirugía de Nervios Periféricos y Plexos, Servicio de Neurocirugía, Hospital de Clínicas, Universidad de Buenos Aires, Buneos Aires, Argentina ; Servicio de Neurocirugía, Hospital Británico de Buenos Aires, Buneos Aires, Argentina ; Servicio de Neurocirugía, Instituto de Neurociencias, Universidad Favaloro, Buenos AIres, Argentina.
authors.forename: Mariano
authors.initials: M
authors.lastname: Socolovsky
authors.affiliation: Programa de Cirugía de Nervios Periféricos y Plexos, Servicio de Neurocirugía, Hospital de Clínicas, Universidad de Buenos Aires, Buneos Aires, Argentina ; Servicio de Neurocirugía, Hospital Británico de Buenos Aires, Buneos Aires, Argentina ; Servicio de Neurocirugía, Instituto de Neurociencias, Universidad Favaloro, Buenos AIres, Argentina.
authors.forename: Gilda
authors.initials: G
authors.lastname: Di Masi
authors.affiliation: Servicio de Diagnóstico por Imágenes, Instituto de Neurociencias, Universidad Favaloro, Buenos Aires, Argentina.
authors.forename: Daniela
authors.initials: D
authors.lastname: Binaghi
authors.affiliation: Servicio de Neurocirugía, Hospital Padilla, Tucumán, Argentina.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Campero
authors.affiliation: Servicio de Neurocirugía, Hospital Regional Universitario Carlos Haya, Málaga, España.
authors.forename: Miguel Domínguez
authors.initials: MD
authors.lastname: Páez
authors.affiliation: Servicio de Neurología, Instituto de Neurociencias, Universidad Favaloro, Buenos Aires, Argentina.
authors.forename: Alberto
authors.initials: A
authors.lastname: Dubrovsky