Our Summary

This research looked at the effects of surgery on patients with a rare condition called True Neurogenic Thoracic Outlet Syndrome (TNTOS). The study analyzed data from 21 patients who had undergone surgery for the condition. The researchers used a variety of tools to measure patients’ pain levels, hand function, and overall disability before and after surgery.

They found that most patients (90%) experienced less pain after surgery, with 85% of these patients showing a more than 50% reduction in pain. However, only one-third of patients saw an improvement in their hand function, and the majority of patients (93.3%) still had moderate to very severe disability at the end of the study period.

In conclusion, the research suggests that while surgery can significantly reduce pain for TNTOS patients, it is less effective at improving their motor function or overall disability. Therefore, the researchers recommend surgery primarily as a method to control pain, even in severe cases of the condition.

FAQs

  1. What is True Neurogenic Thoracic Outlet Syndrome (TNTOS) and what were the findings of the study on its surgical treatment?
  2. How effective is surgery at reducing pain and improving hand function in patients with TNTOS?
  3. What do the researchers recommend as the primary purpose of surgery for TNTOS patients?

Doctor’s Tip

A doctor might tell a patient considering thoracic outlet syndrome surgery that while the procedure can help reduce pain, it may not necessarily improve hand function or overall disability. It’s important for patients to have realistic expectations about the potential outcomes of surgery and to discuss any concerns or questions with their healthcare provider before making a decision. Additionally, post-operative rehabilitation and physical therapy may be necessary to help improve hand function and overall function after surgery.

Suitable For

Thoracic outlet syndrome surgery is typically recommended for patients who have not responded to conservative treatments such as physical therapy, medication, and nerve blocks. Patients who have severe pain, weakness, numbness, or tingling in their arms and hands, as well as those who have muscle atrophy or vascular symptoms, may be candidates for surgery. Additionally, patients with a confirmed diagnosis of True Neurogenic Thoracic Outlet Syndrome (TNTOS) may benefit from surgery to alleviate their symptoms. It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if surgery is the best course of action for their specific condition.

Timeline

Before surgery, patients typically experience symptoms such as shoulder and neck pain, numbness or tingling in the arms or hands, weakness in the arms, and difficulty performing daily activities. These symptoms may worsen with certain movements or positions, such as reaching overhead or carrying heavy objects.

After surgery, patients may experience immediate relief from their symptoms, particularly in terms of pain. Over time, they may also see improvements in their ability to use their hands and arms, as well as increased overall function and quality of life. Physical therapy and rehabilitation are often recommended to help patients regain strength and mobility in the affected area.

It is important for patients to follow their surgeon’s post-operative instructions carefully and attend follow-up appointments to monitor their progress and address any concerns. With proper care and rehabilitation, many patients are able to return to their normal activities and enjoy an improved quality of life after thoracic outlet syndrome surgery.

What to Ask Your Doctor

Questions a patient should ask their doctor about thoracic outlet syndrome surgery include:

  1. What are the potential risks and complications associated with thoracic outlet syndrome surgery?
  2. How long is the recovery process after surgery, and what can I expect in terms of pain and limitations during this time?
  3. What are the success rates for this type of surgery in terms of pain relief and improvement in hand function?
  4. Are there any alternative treatment options available for thoracic outlet syndrome that I should consider before opting for surgery?
  5. How experienced are you in performing thoracic outlet syndrome surgery, and what is your success rate with this procedure?
  6. Will I need physical therapy or other forms of rehabilitation after surgery, and if so, what will this process entail?
  7. How likely is it that my symptoms will improve or worsen over time after surgery, and what steps can I take to ensure the best possible outcome?
  8. Are there any lifestyle changes or modifications I should make after surgery to prevent a recurrence of thoracic outlet syndrome in the future?
  9. Can you provide me with any patient testimonials or success stories from individuals who have undergone thoracic outlet syndrome surgery with you?
  10. What is the expected long-term prognosis for someone who undergoes thoracic outlet syndrome surgery, and what follow-up care will be necessary to monitor my progress?

Reference

Authors: Martins RS, Zaccariotto M, Siqueira MG, Heise CO, Neto HS, Teixeira MJ. Journal: Acta Neurochir (Wien). 2022 Oct;164(10):2673-2681. doi: 10.1007/s00701-022-05319-2. Epub 2022 Jul 29. PMID: 35906353