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Neurogenic tos

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https://www.readbyqxmd.com/read/28735950/associations-between-clinical-diagnostic-criteria-and-pretreatment-patient-reported-outcomes-measures-in-a-prospective-observational-cohort-of-patients-with-neurogenic-thoracic-outlet-syndrome
#1
Joshua Balderman, Katherine Holzem, Beverly J Field, Michael M Bottros, Ahmmad A Abuirqeba, Chandu Vemuri, Robert W Thompson
OBJECTIVE: Neurogenic thoracic outlet syndrome (NTOS) is caused by dynamic compression of the brachial plexus at the level of the supraclavicular scalene triangle or the subcoracoid (pectoralis minor) space, or both. The purpose of this study was to characterize relationships between 14 clinical diagnostic criteria (CDC) and seven pretreatment patient-reported outcomes measures (PROMs) in a prospective cohort of patients with NTOS. METHODS: There were 183 new patient referrals between July 1 and December 31, 2015, with 150 (82%) meeting an established set of predefined CDC for NTOS...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28677632/ultrasonographic-diagnosis-of-thoracic-outlet-syndrome-secondary-to-brachial-plexus-piercing-variation
#2
Vanessa Leonhard, Gregory Caldwell, Mei Goh, Sean Reeder, Heather F Smith
Structural variations of the thoracic outlet create a unique risk for neurogenic thoracic outlet syndrome (nTOS) that is difficult to diagnose clinically. Common anatomical variations in brachial plexus (BP) branching were recently discovered in which portions of the proximal plexus pierce the anterior scalene. This results in possible impingement of BP nerves within the muscle belly and, therefore, predisposition for nTOS. We hypothesized that some cases of disputed nTOS result from these BP branching variants...
July 4, 2017: Diagnostics
https://www.readbyqxmd.com/read/28644402/choosing-surgery-for-neurogenic-tos-the-roles-of-physical-exam-physical-therapy-and-imaging
#3
REVIEW
David P Kuwayama, Jason R Lund, Charles O Brantigan, Natalia O Glebova
Neurogenic thoracic outlet syndrome (nTOS) is characterized by arm and hand pain, paresthesias, and sometimes weakness resulting from compression of the brachial plexus within the thoracic outlet. While it is the most common subtype of TOS, nTOS can be difficult to diagnose. Furthermore, patient selection for surgical treatment can be challenging as symptoms may be vague and ambiguous, and diagnostic studies may be equivocal. Herein, we describe some approaches to aid in identifying patients who would be expected to benefit from surgical intervention for nTOS...
June 23, 2017: Diagnostics
https://www.readbyqxmd.com/read/28616159/thoracic-outlet-syndrome-as-a-consequence-of-isolated-atraumatic-first-rib-fracture
#4
Aleem K Mirza, Audra A Duncan
Neurogenic thoracic outlet syndrome (nTOS) resulting from an isolated first rib fracture is extremely infrequent. We report a case of performance limiting nTOS in a college athlete who was initially evaluated and treated for upper extremity ligamentous injury with only transient improvement. Subsequent noninvasive studies were consistent with TOS physiology and MRA showed a large hypertrophic callus on the first rib adjacent to the brachial plexus. With continued athletic limitations and radiographic findings consistent with TOS, surgical decompression was performed resulting in resolution of symptoms...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28604581/vascular-tos-creating-a-protocol-and-sticking-to-it
#5
REVIEW
Meena Archie, David Rigberg
Thoracic Outlet Syndrome (TOS) describes a set of disorders that arise from compression of the neurovascular structures that exit the thorax and enter the upper extremity. This can present as one of three subtypes: neurogenic, venous, or arterial. The objective of this section is to outline our current practice at a single, high-volume institution for venous and arterial TOS. VTOS: Patients who present within two weeks of acute deep vein thrombosis (DVT) are treated with anticoagulation, venography, and thrombolysis...
June 10, 2017: Diagnostics
https://www.readbyqxmd.com/read/28579292/current-practice-of-thoracic-outlet-decompression-surgery-in-the-united-states
#6
Elena K Rinehardt, John E Scarborough, Kyla M Bennett
BACKGROUND: Thoracic outlet syndrome (TOS) and its management are relatively controversial topics. Most of the literature reporting the outcomes of surgical decompression for TOS derives from single-center experiences. The objective of our study was to describe the current state of TOS surgery among hospitals that participate in the American College of Surgeons National Surgical Quality Improvement Program database. METHODS: Our study sample consisted of patients from the 2005 to 2014 American College of Surgeons National Surgical Quality Improvement Program database who underwent first or cervical rib resection as their index procedure and whose constellation of diagnosis and procedure codes identified them as having neurogenic, arterial, or venous TOS...
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28555024/new-diagnostic-and-treatment-modalities-for-neurogenic-thoracic-outlet-syndrome
#7
REVIEW
M Libby Weaver, Ying Wei Lum
Neurogenic thoracic outlet syndrome is a widely recognized, yet controversial, syndrome. The lack of specific objective diagnostic modalities makes diagnosis difficult. This is compounded by a lack of agreed upon definitive criteria to confirm diagnosis. Recent efforts have been made to more clearly define a set of diagnostic criteria that will bring consistency to the diagnosis of neurogenic thoracic syndrome. Additionally, advancements have been made in the quality and techniques of various imaging modalities that may aid in providing more accurate diagnoses...
May 27, 2017: Diagnostics
https://www.readbyqxmd.com/read/28537129/perioperative-outcomes-of-thoracic-outlet-syndrome-surgical-repair-in-a-nationally-validated-database
#8
Besma Nejim, Husain N Alshaikh, Isibor Arhuidese, Tammam Obeid, Ying Wei Lum, Joseph Canner, Satinderjit S Locham, Mahmoud Malas
We evaluated the occurrence of thoracic outlet syndrome (TOS) and 30-day postoperative outcomes. Patients undergoing cervical/first rib resection surgery were identified in the American College of Surgeons National Surgical Quality Improvement Program database (2005-2013). Thoracic outlet syndrome types were then examined. Propensity score matching was performed to account for potential confounders; 1180 patients were explored during the study period, 1007 (85.3%) were of the neurogenic TOS (NTOS), 32 (2.7%) patients had arterial TOS (ATOS), and 141 (12...
July 2017: Angiology
https://www.readbyqxmd.com/read/28493011/mri-of-thoracic-outlet-syndrome-in-children
#9
REVIEW
Govind B Chavhan, Vaishnavi Batmanabane, Prakash Muthusami, Alexander J Towbin, Gregory H Borschel
Thoracic outlet syndrome is caused by compression of the neurovascular bundle as it passes from the upper thorax to the axilla. The neurovascular bundle can be compressed by bony structures such as the first rib, cervical ribs or bone tubercles, or from soft-tissue abnormalities like a fibrous band, muscle hypertrophy or space-occupying lesion. Thoracic outlet syndrome commonly affects young adults but can be seen in the pediatric age group, especially in older children. Diagnosis is based on a holistic approach encompassing clinical features, physical examination findings including those triggered by various maneuvers, electromyography, nerve conduction studies and imaging...
May 10, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28479443/postoperative-pain-management-following-thoracic-outlet-decompression
#10
Mathew Wooster, Dana Reed, Adam Tanious, Karl Illig
BACKGROUND: Thoracic outlet decompression (TOD) is associated with significant postoperative pain often leading to hospital length of stay out of proportion to the risk profile of the operation. We seek to describe the improvement in hospital length of stay and patient pain control with an improved multiagent pain management regimen. METHODS: We retrospectively reviewed the hospital length of stay, medication regimen/usage, operative details, and operative indications for all patients undergoing TOD from January 2012 through June 2015...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28427870/all-endoscopic-brachial-plexus-complete-neurolysis-for-idiopathic-neurogenic-thoracic-outlet-syndrome-a-prospective-case-series
#11
Thibault Lafosse, Malo Le Hanneur, Laurent Lafosse
PURPOSE: To describe an all-endoscopic technique for infra- and supraclavicular brachial plexus (BP) neurolysis and to assess its functional outcomes for patients suffering from nonspecific neurogenic thoracic outlet syndrome (NTOS). METHODS: Between January 2010 and January 2013, 36 patients presenting an idiopathic nonspecific NTOS benefited from an endoscopic decompression in our institution. The inclusion criteria were a typical clinical NTOS and failure of a 6-month well-conducted nonsurgical treatment...
August 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28303559/-thoracic-outlet-syndrome
#12
Sven Seifert, Pavel Sebesta, Marian Klenske, Mirko Esche
Introduction Thoracic outlet syndrome (TOS) is one of the most extensively discussed diagnoses. There is neither a clear and homogenous clinical presentation nor an accepted definition. The term describes a complex of symptoms and complaints caused by the compression of nerves and vascular structures at one of the three defined constrictions of the upper thoracic aperture. Methods Based on a comprehensive literature review, this article presents the etiology, epidemiology and clinical diagnostics as well as the possibilities and outcomes of surgical treatment...
February 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28135679/an-unusual-case-of-neurogenic-thoracic-outlet-syndrome
#13
Yash Vaidya, Rajan Vaithianathan
INTRODUCTION: Neurogenic thoracic outlet syndrome (nTOS) is the most common manifestation of thoracic outlet syndrome (TOS), accounting for more than 95% of cases. It is usually caused by cervical ribs, anomalies in the scalene muscle anatomy or post-traumatic inflammatory changes causing compression of the brachial plexus. CASE PRESENTATION: We present an unusual case of nTOS caused by a cystic lymphangioma at the thoracic outlet, with only one case reported previously in the literature...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28018833/aneurysmal-bone-cyst-arising-from-the-first-rib-a-rare-cause-of-thoracic-outlet-syndrome
#14
Manuel Medina, Subroto Paul
Aneurysmal bone cyst is a rare benign cystic bone lesion with an incidence of only 0.14 per 100,000 individuals and most commonly affects the metaphyses of long bones, spine, and pelvis. We present a very rare case of a 17-year-old boy with a rapidly expanding aneurysmal bone cyst arising from the first rib, resulting in neurogenic thoracic outlet syndrome secondary to its compression of the brachial plexus. The patient's symptoms resolved after en bloc resection. To our knowledge there have been no other reports in the literature of thoracic outlet syndrome due to aneurysmal bone cyst arising from the first rib...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28006856/the-thoracic-outlet-syndromes-part-2-the-arterial-venous-neurovascular-and-disputed-thoracic-outlet-syndromes
#15
Mark A Ferrante, Nicole D Ferrante
The thoracic outlet syndromes (TOSs) are a group of etiologically and clinically distinct disorders with 1 feature in common: compression of 1 or more neurovascular elements as they traverse the thoracic outlet. The medical literature reflects 5 TOSs: arterial; venous; traumatic neurovascular; true neurogenic; and disputed. Of these, the first 4 demonstrate all of the features expected of a syndrome, whereas disputed TOS does not, causing many experts to doubt its existence altogether. Thus, some categorize disputed TOSs as cervicoscapular pain syndrome rather than as a type of TOS...
December 22, 2016: Muscle & Nerve
https://www.readbyqxmd.com/read/28006844/the-thoracic-outlet-syndromes-part-1-overview-of-the-thoracic-outlet-syndromes-and-review-of-true-neurogenic-thoracic-outlet-syndrome
#16
Mark A Ferrante, Nicole D Ferrante
The thoracic outlet syndromes (TOSs) are a group of etiologically and clinically distinct disorders with 1 feature in common: compression of 1 or more neurovascular elements as they traverse the thoracic outlet. The medical literature reflects 5 TOSs: arterial; venous; traumatic neurovascular; true neurogenic; and disputed. Of these, the first 4 demonstrate all of the features expected of a syndrome, whereas disputed TOS does not, causing many experts to doubt its existence altogether. Thus, some categorize disputed TOS as a cervicoscapular pain syndrome rather than as a type of TOS...
June 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28002866/botulinum-toxin-injections-in-musculoskeletal-disorders
#17
REVIEW
Ivan R B Godoy, Dean M Donahue, Martin Torriani
Botulinum toxin (BTX) is used for multiple clinical indications due to its ability to induce temporary chemodenervation and muscle paralysis. This property has supported its application in treating a variety of musculoskeletal conditions, especially those involving muscular hyperactivity and contractures such as cerebral palsy and dystonia. However, off-label use of BTX injection in other musculoskeletal disorders is gaining increased acceptance, such as in neurogenic thoracic outlet syndrome, epicondylitis, and shoulder pain after stroke...
November 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27989967/modified-interscalene-approach-for-resection-of-symptomatic-cervical-rib-anatomic-review-and-clinical-study
#18
Walid Abdel Ghany, Mohamed A Nada, Ahmed F Toubar, Ahmed E Desoky, Hesham Ibrahim, Marwa A Nassef, Mostafa G Mahran
BACKGROUND: Cervical ribs have been reported to be present in about 0.5% of the general population, 10% of patients with cervical rib who are symptomatic usually have neurogenic symptoms, but some have arterial symptoms. In 1861, Coote was the first to excise a cervical rib through a supraclavicular approach and relieved the symptoms of thoracic outlet syndrome. OBJECTIVE: In this study, we address the efficacy and safety of a modification to the supraclavicular approach for resection of symptomatic cervical ribs...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27987052/thoracic-outlet-syndrome-wide-literature-for-few-cases-status-of-the-art
#19
REVIEW
Pietro Emiliano Doneddu, Daniele Coraci, Paola De Franco, Ilaria Paolasso, Pietro Caliandro, Luca Padua
Despite its low prevalence and incidence, considerable debate exists in the literature on thoracic outlet syndrome (TOS). From literature analysis on nerve entrapments, we realized that TOS is the second most commonly published entrapment syndrome in the literature (after carpal tunnel syndrome) and that it is even more reported than ulnar neuropathy at elbow, which, instead, is very frequent. Despite the large amount of articles, there is still controversy regarding its classification, clinical picture, diagnostic objective findings, diagnostic modalities, therapeutical strategies and outcomes...
March 2017: Neurological Sciences
https://www.readbyqxmd.com/read/27979572/a-fourteen-year-experience-with-vascular-anomalies-encountered-during-transaxillary-rib-resection-for-thoracic-outlet-syndrome
#20
Jeniann A Yi, Robert J Johnston, Mark R Nehler, Douglas R Gibula, Kristen Alix, Natalia O Glebova, Charles O Brantigan
BACKGROUND: Transaxillary approach to first rib resection and scalenectomy (TAFRRS) is a well-established technique for treatment of thoracic outlet syndrome (TOS). Although anatomic features encountered during TAFRRS are in general constant, vascular anomalies may be encountered but have not been described to date. Herein we describe vascular abnormalities encountered during TAFRRS. METHODS: We performed a retrospective review of a prospective practice database of 224 operations for TOS performed in 172 patients from March 2000 to March 2014...
December 12, 2016: Annals of Vascular Surgery
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