title: Work-Related Neurogenic Thoracic Outlet Syndrome: Diagnosis and Treatment.
abstract: Outcomes of surgery for neurogenic thoracic outlet syndrome (NTOS) in workers' compensation are poor in a majority of patients, partly due to nonspecificity of diagnosis. Most cases have no objective evidence of the presence of brachial plexus dysfunction. Up to 20% of patients experience a new adverse event. Objective neurologic signs and electrodiagnostic evidence of brachial plexus dysfunction must be present before proceeding with invasive procedures. This guideline includes objective criteria that must be met before thoracic outlet syndrome surgery can be approved in Washington State. Evidence does not support the use of scalene blocks, botulinum toxin therapy, or vascular studies to diagnose NTOS.
authors.affiliation: Washington State Department of Labor and Industries, Olympia, WA 98501, USA; University of Washington, Department of Environmental and Occupational Health Sciences; Department of Neurology; Department of Health Services. Electronic address: fral235@lni.wa.gov.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Franklin
mesh_terms: D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D009787:Occupational Medicine / Q000379:methods*; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis / Q000191:economics / Q000628:therapy; D014942:Workers' Compensation
keywords: Diagnosis; Practice guidelines; Thoracic outlet syndrome; Treatment; Workers’ compensation