Our Summary

The researchers studied a condition called Thoracic Outlet Syndrome (TOS), which is a group of problems caused by pressure on the nerves or blood vessels near the neck and collarbone. They collected data from patients who visited their clinic from 2014 to 2018. They found that of the 526 patients referred to them, 82% had symptoms suggesting they had the nerve-related form of TOS (NTOS), 16% had symptoms of the vein-related form (VTOS), and 2% had symptoms of the artery-related form (ATOS). After further examination, they concluded that 83% of the patients referred did possibly have NTOS, and of the patients with VTOS, 30% had acute Paget-Schroetter syndrome, 48% had subacute or chronic occlusion, and 21% had McCleery’s syndrome. They figured out that the number of people who get NTOS every year is between 2 and 3 out of every 100,000 people, and the number who get VTOS is between 0.5 and 1 out of every 100,000 people. ATOS was very rare. These numbers are lower than previous estimates, but still significant.

FAQs

  1. What is Thoracic Outlet Syndrome (TOS) and what causes it?
  2. What are the different forms of Thoracic Outlet Syndrome (TOS) and how often do they occur?
  3. What are Paget-Schroetter syndrome and McCleery’s syndrome in relation to vein-related Thoracic Outlet Syndrome (VTOS)?

Doctor’s Tip

After thoracic outlet syndrome surgery, it is important to follow the post-operative care instructions provided by your surgeon. This may include exercises to improve strength and flexibility in the affected area, as well as proper wound care to prevent infection. It is also important to attend follow-up appointments with your doctor to monitor your progress and address any concerns. Additionally, it is important to avoid activities that may aggravate the surgical site until cleared by your doctor.

Suitable For

Patients who are typically recommended thoracic outlet syndrome surgery are those who have severe and persistent symptoms that do not improve with conservative treatments such as physical therapy or medications. These symptoms may include pain, numbness, weakness, or tingling in the arm, shoulder, or neck, as well as difficulty performing daily activities. Patients with a confirmed diagnosis of nerve-related TOS (NTOS) or vein-related TOS (VTOS) may be candidates for surgery, depending on the severity of their condition and their individual circumstances. Patients with artery-related TOS (ATOS) may also be recommended for surgery in certain cases, although this form of TOS is rare. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine the most appropriate course of action.

Timeline

Before thoracic outlet syndrome surgery:

  • Patient experiences symptoms such as pain, numbness, tingling, weakness, or discoloration in the arm, shoulder, or hand
  • Patient undergoes diagnostic tests such as physical examination, imaging tests, and nerve conduction studies to confirm the diagnosis of TOS
  • Patient may undergo conservative treatments such as physical therapy, medications, and lifestyle modifications to manage symptoms

After thoracic outlet syndrome surgery:

  • Patient undergoes surgery to relieve pressure on the nerves or blood vessels in the thoracic outlet
  • Recovery period varies depending on the type of surgery performed, but typically involves physical therapy and pain management
  • Patient may experience improvement in symptoms such as decreased pain, improved strength and range of motion, and better circulation in the affected arm
  • Patient follows up with healthcare provider for monitoring and further treatment as needed

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 period after thoracic outlet syndrome surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What are the success rates of thoracic outlet syndrome surgery?
  5. Are there any alternative treatment options to consider before opting for surgery?
  6. How long do the effects of the surgery typically last?
  7. Will I need to make any lifestyle changes or modifications after the surgery?
  8. How experienced is the surgical team in performing thoracic outlet syndrome surgery?
  9. What type of anesthesia will be used during the surgery?
  10. What is the expected outcome or prognosis after thoracic outlet syndrome surgery?

Reference

Authors: Illig KA, Rodriguez-Zoppi E, Bland T, Muftah M, Jospitre E. Journal: Ann Vasc Surg. 2021 Jan;70:263-272. doi: 10.1016/j.avsg.2020.07.029. Epub 2020 Aug 6. PMID: 32771464