title: A modified, less invasive posterior subscapular approach to the brachial plexus: case report and technical note.
abstract: The traditional posterior subscapular approach offers excellent exposure of the lower brachial plexus and has been successfully used in patients with recurrent thoracic outlet syndrome after an anterior operation, brachial plexus tumors involving the proximal roots, and postirradiation brachial plexopathy, among others. However, this approach also carries some morbidity, mostly related to the extensive muscle dissection of the trapezius, rhomboids, and levator scapulae. In this article, the authors present the surgical technique and video illustration of a modified, less invasive posterior subscapular approach, using a small, self-retaining retractor and only a partial trapezius and rhomboid minor muscle dissection. This approach is likely to result in decreased postoperative morbidity and a shorter hospital stay.
authors.affiliation: Department of Neurosurgery, Louisiana State University, New Orleans, Louisiana.
authors.forename: Clifford L
authors.initials: CL
authors.lastname: Crutcher
authors.affiliation: Department of Neurosurgery, Louisiana State University, New Orleans, Louisiana.
authors.forename: David G
authors.initials: DG
authors.lastname: Kline
authors.affiliation: Department of Neurosurgery, Louisiana State University, New Orleans, Louisiana.
authors.forename: Gabriel C
authors.initials: GC
authors.lastname: Tender
mesh_terms: D001917:Brachial Plexus / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D012540:Scapula / Q000000981:diagnostic imaging / Q000601:surgery*; D013901:Thoracic Outlet Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: TOS = thoracic outlet syndrome; brachial plexus; posterior subscapular approach; thoracic outlet syndrome