Our Summary

The study looked at teenage athletes who had two types of thoracic outlet syndrome (TOS), a condition that affects the area between the collarbone and the first rib. Those two types were venous TOS (VTOS) and neurogenic TOS (NTOS). The goal was to compare how well these athletes did after having surgery to treat the condition.

The researchers looked at data from athletes aged 13-19 who had the surgery between 1996 and 2021. They looked at information like age, symptoms before the surgery, details about the surgery itself, and how the athletes did after the surgery. They were particularly interested in whether the athletes could return to their sport after the surgery, if their symptoms got better, and their scores on certain pain and function tests.

They found that out of 60 patients, 40% had VTOS and 60% had NTOS. The NTOS patients were more likely to be female and had more severe symptoms before the surgery, but less swelling. All the VTOS patients had a specific type of surgery, as did most of the NTOS patients. Some NTOS patients also had other procedures.

After the surgery, they found that there was no significant difference in how many athletes from each group could return to their sport. They also found that most symptoms got better after the surgery. There were significant differences in the scores on the pain and function tests between the two groups both before and after the surgery. However, there was no clear link between these scores before the surgery and whether the athletes could return to their sport.

The study concluded that teenage athletes with both types of TOS can do well and return to their sport after surgery. They also found that NTOS patients had more severe symptoms and other injuries before the surgery. Some athletes couldn’t return to their sport after the surgery because of other health issues.

FAQs

  1. What is the difference between venous TOS (VTOS) and neurogenic TOS (NTOS)?
  2. What were the outcomes of the surgery for teenage athletes with TOS? Could they return to their sport?
  3. Was there a link between the severity of symptoms before surgery and the ability to return to sport after surgery in athletes with TOS?

Doctor’s Tip

A helpful tip a doctor might tell a patient about thoracic outlet syndrome surgery is to follow post-operative instructions carefully, including any physical therapy or rehabilitation exercises prescribed. It is important to give your body time to heal and regain strength before returning to sports or strenuous activities. Be sure to communicate with your healthcare provider about any concerns or changes in symptoms during the recovery process.

Suitable For

Patients who are typically recommended thoracic outlet syndrome surgery are those who have severe symptoms that significantly impact their daily life and ability to participate in physical activities, such as athletes. Additionally, patients who have not responded well to conservative treatments like physical therapy or medication may also be candidates for surgery. The decision to recommend surgery is usually made after a thorough evaluation by a healthcare provider to determine the underlying cause of the TOS and the potential benefits of surgery.

Timeline

Overall, the timeline of a patient’s experience before and after thoracic outlet syndrome surgery would typically involve:

Before Surgery:

  1. Experiencing symptoms such as pain, numbness, weakness, or swelling in the neck, shoulder, and arm.
  2. Visiting a healthcare provider for diagnosis and evaluation of TOS.
  3. Undergoing imaging tests such as X-rays, MRI, or ultrasound to confirm the diagnosis.
  4. Trying conservative treatments like physical therapy, medication, or lifestyle changes to manage symptoms.
  5. Deciding with a healthcare provider to undergo surgery if conservative treatments are not effective.

After Surgery:

  1. Preparing for the surgical procedure, which may involve pre-operative tests and consultations.
  2. Undergoing surgery to relieve compression of the nerves or blood vessels in the thoracic outlet.
  3. Recovering in the hospital for a few days post-surgery.
  4. Starting physical therapy and rehabilitation to regain strength and mobility in the affected arm and shoulder.
  5. Monitoring symptoms and progress in follow-up appointments with the healthcare provider.
  6. Gradually returning to normal activities, including sports, as symptoms improve and strength is regained.

Overall, the timeline can vary depending on the individual patient’s condition, the type of surgery performed, and their overall health and recovery process. It is important for patients to follow their healthcare provider’s recommendations and participate in rehabilitation to achieve the best possible outcome after TOS surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with thoracic outlet syndrome surgery?

  2. How long is the recovery process after thoracic outlet syndrome surgery?

  3. Will physical therapy be necessary after the surgery, and if so, for how long?

  4. What type of rehabilitation plan will be recommended after the surgery?

  5. How soon after the surgery can I expect to see improvement in my symptoms?

  6. Are there any specific activities or movements I should avoid after the surgery?

  7. What is the success rate of thoracic outlet syndrome surgery in terms of symptom improvement and return to normal function?

  8. Are there any long-term effects or potential complications I should be aware of after the surgery?

  9. Will I need to follow up with a specialist or physical therapist post-surgery?

  10. Are there any alternative treatment options to consider before opting for surgery?

Reference

Authors: Talutis SD, Ulloa JG, Gelabert HA. Journal: J Vasc Surg. 2023 Feb;77(2):599-605. doi: 10.1016/j.jvs.2022.10.002. Epub 2022 Oct 12. PMID: 36243264