Thoracic Outlet Syndrome Current Concepts of Treatment

Abstract

The surgical treatment of the thoracic outlet syndrome in 304 patients resulted in complete (85%) or partial (7%) relief of symptoms in 92% of operated patients. The diagnosis centers upon a thorough history and the exclusion of other causes of arm and shoulder pain utilizing a strict flow pattern of differential diagnosis. Angiography and electromyography are of limited value and are only performed in selected cases. Operation should be reserved for the thoroughly evaluated patient who continues to have pain despite adequate conservative therapy. Transaxillary removal of the 1st rib, fibromuscular bands and cervical rib, when present, is the operation of choice.