Relevance of Costovertebral Exarticulation of the First Rib in Neurogenic Thoracic Outlet Syndrome: A Retrospective Clinical Study

被引:5
作者
Lassner, Franz [1 ]
Becker, Michael [1 ]
Prescher, Andreas [2 ]
机构
[1] Pauwelsklinik, Boxgraben 56, D-52064 Aachen, Germany
[2] Rhein Westfal TH Aachen, Inst Mol & Cellular Anat, Pauwelsstr 30, D-52074 Aachen, Germany
来源
JOURNAL OF PERSONALIZED MEDICINE | 2023年 / 13卷 / 01期
关键词
neurogenic thoracic outlet syndrome; nerve compression syndrome; costoclavicular exarticulation; SURGERY;
D O I
10.3390/jpm13010144
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Purpose: The failure rate for operative decompression in neurogenic thoracic outlet syndrome (NTOS) is high compared to more distal nerve compression syndromes, such as cubital or carpal tunnel syndrome. Herein, we aimed to determine if a more radical approach, namely costovertebral exarticulation of the first rib, may improve the postoperative results in patients with NTOS. Methods: From October 2002 to December 2020, 105 operative decompressions in 95 patients were evaluated; in 10 cases, decompressions were performed bilaterally. We presented the clinical outcomes of 59 exarticulations compared to those of 46 conventional resections. Evaluation was performed at a minimum of one year post-operation using the DASH questionnaire. Results: The exarticulation group presented with significantly better clinical outcomes (two-sample t-test assuming unequal variances, p < 0.001). Conclusions: This study showed that significantly better results were obtained when exarticulation of the first rib was performed in patients with NTOS. This finding supports the hypothesis that, in certain cases, the proximal portion of the first rib plays a pivotal role in the pathogenesis of NTOS.
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页数:9
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