Imaging features of the brachial plexus in neurogenic thoracic outlet syndrome: A case report.

Neurogenic thoracic outlet syndrome (NTOS) is characterized by the compression of the brachial plexus in the thoracic outlet region, caused by various etiologies. We report a case with clinical symptoms and imaging findings from ultrasound and magnetic resonance imaging (MRI) of NTOS due to an elongated C7 transverse process and a fibrous band of the middle scalene muscle, which was confirmed in decompression surgery.

Endoscopic-Assisted Infraclavicular Approach for Hypoplastic First Rib Resection in Thoracic Outlet Syndrome: A Case Report.

Case: A 25-year-old man presented with neck and upper-limb pain. He underwent surgery for the resection of a left hypoplastic first rib, which was causing thoracic outlet syndrome. The subclavian vein was retracted through an infraclavicular incision, and an endoscope was inserted dorsally to the vein.

T1WI Radiomics Analysis of Anterior Scalene Muscle: A Preliminary Application in Neurogenic Thoracic Outlet Syndrome.

Aim: This study aimed to analyze the differences in radiomic features of the anterior scalene muscle and evaluate the diagnostic performance of MRI-based radiomics model for neurogenic thoracic outlet syndrome (NTOS).

Materials And Methods: Imaging data of patients with NTOS who underwent preoperative brachial plexus magnetic resonance neurography were collected and were randomly divided into training and test groups. The anterior scalene muscle area was sliced in the T1WI sequence as the region of interest for the extraction of radiomics features.

The management of thoracic outlet syndrome induced by bilateral cervical ribs in young, female athlete - a case report.

Introduction: The presence of additional cervical ribs is a rare and relatively unknown pathology. The brachial plexus is most often compressed. Thoracic Outlet Syndrome (TOS) is the one of discussed of mixed compression syndromes, due to diagnostic difficulties and the lack of evidence to resolve the effectiveness of surgical treatment over conservative treatment.

Intractable pain due to thoracic outlet syndrome successfully treated with percutaneous epidural adhesiolysis: A case report.

Thoracic outlet syndrome (TOS) is characterized by intractable cervicobrachial pain caused by strangulation of the brachial plexus and subclavian artery by structures of the superior thoracic outlet. We describe percutaneous epidural adhesiolysis for refractory pain due to TOS. A man in his 40s had received nerve block therapy for right upper extremity pain of unknown origin for 5 years.

Burden of In-Hospital Admissions and Outcomes of Thoracic Outlet Compression Syndrome in the United States From 2010 to 2021.

Introduction Despite advancements in medical and surgical management, thoracic outlet syndrome (TOS) remains a complex and often understudied condition with variable outcomes. This study assessed hospitalization rates and outcomes, including patient characteristics, mortality risks, and healthcare costs associated with TOS hospitalizations. Methods We analyzed elective and nonelective hospitalization data for TOS between 2010 and 2021 from the National Inpatient Sample (NIS) and National Readmission Databases (NEDS) and classified the data into neurogenic, venous, and arterial subtypes using the International Classification of Diseases (ICD) diagnostic and procedural codes.

Treatment of thoracic outlet syndrome to relieve chronic migraine.

Prior case reports have suggested that treating thoracic outlet syndrome (TOS) may relieve intractable migraine headaches, but there has been no case series large enough to show when underlying TOS should be suspected as a contributor to migraine burden. This observational followed by questionnaire study was performed in an outpatient neurology practice to identify clinical features of patients with migraine in which TOS contributed to migraine burden. We report the clinical features of 50 consecutive patients (48 women, 2 men, age = 43.

3D printing of the brachial plexus and its osseous landmarks using magnetic resonance neurography for thoracic outlet syndrome evaluation.

Background: Patient-specific three-dimensional (3D) printed anatomic models are valuable clinical tools that facilitate enhanced visualization of pertinent anatomic structures and have demonstrated benefits of reduced surgical times, increased surgeon confidence, and improved operative results and subsequent patient outcomes. Medical image-based 3D printed anatomic models are generally created from computed tomography (CT), however magnetic resonance imaging (MRI), which offers exquisite soft tissue characterization and flexible contrast avoiding the use of ionizing radiation, is an attractive alternative. Herein, the application of 3D printing incorporating both MR neurography and zero-echo time (ZTE) MRI for visualization of the brachial plexus anatomy in a subject with thoracic outlet syndrome (TOS) is described.

A Literature Review of Methods of Perioperative Pain Management in Thoracic Outlet Decompression.

Objectives: Post-operative pain control in thoracic outlet decompression (TOD) is difficult due to the complex innervation of the anatomical region. Poor post-operative pain control has been associated with worse patient experiences and prolonged inpatient stays. This study aims to identify evidence-based peri-operative analgesic strategies for thoracic outlet decompression.

T1 erector spinae plane block for first rib resections in patients with thoracic outlet syndrome: a case series.

An erector spinae plane block (ESPB), in which a local anesthetic is injected into the plane anterior to the erector spinae muscles, is a relatively new technique for delivering regional anesthesia and is typically performed in the mid-thoracic region. ESPBs demonstrate great potential to control regional neuropathic pain, and, accordingly, may be particularly effective at the T1 level for controlling pain in patients undergoing first rib resections for thoracic outlet syndrome (TOS). Four patients undergoing first rib resections for TOS were administered an ultrasound-guided ESPB at the T1 level.

Utilization and Effectiveness of Pectoralis Minor Tenotomy in the Surgical Management of Neurogenic Thoracic Outlet Syndrome.

Background: Uncertainty exists concerning the optimal utilization and effectiveness of pectoralis minor tenotomy (PMT) in neurogenic thoracic outlet syndrome (NTOS).

Methods: Between January 2020 and July 2023, 355 patients with NTOS underwent primary surgical treatment. Prospectively collected data were analyzed retrospectively.

Large Right Subclavian Artery Aneurysm Presenting in a Young Patient.

Subclavian artery aneurysms are extremely rare, accounting for less than 1% all of peripheral aneurysms. They are often due to atherosclerosis or thoracic outlet syndrome and present at an average age of 47 years. Here, we present an incidental finding of an 18 mm rapidly increasing aneurysm involving the first and second part of the right subclavian artery in a woman in her 20s.

Early Results of Interventions in Patients with Venous Thoracic Outlet Syndrome.

Background: To determine the freedom from major complications and the efficacy, in the form of technical and clinical success, of different interventions in venous thoracic outlet syndrome (VTOS).

Methods: Data from 3 centers regarding patients aged between (18 and 60 years) with symptoms and signs of upper limb venous outflow obstruction was collected and analyzed to monitor outcome of different interventions.

Results: 23 patients (16 males) with mean age of 35 ± 9.

Atypical articulation of the cervical rib and first rib.

The cervical rib is an additional rib arising from the transverse process of the seventh cervical vertebra. This rib may terminate free in soft tissue or may be attached to the first rib. The cervical rib is a congenital anomaly that occurs in less than 1% of the general population and sometimes causes severe symptoms of thoracic outlet syndrome.

Novel Diagnosis and Treatment for Neurogenic Thoracic Outlet Syndrome.

This article presents a unique diagnostic test for the neurogenic thoracic outlet syndrome (nTOS). nTOS is one of the most misdiagnosed and controversial medical problems; the diagnosis is clinical, and there are few specific diagnostic criteria for this condition. We would like to share this unique diagnostic modality, the Tafler test, with medical professionals.