Open AccessEvaluation and Management of Neurogenic Thoracic Outlet Syndrome with an Overview of Surgical Approaches: A Comprehensive Review
Author(s) -
Christine Lim,
Yasaman Kavousi,
Ying Wei Lum,
Paul J. Christo
Publication year - 2021
Publication title -
journal of pain research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 49
ISSN - 1178-7090
DOI - 10.2147/jpr.s282578
Subject(s) - medicine , thoracic outlet syndrome , thoracic outlet , neurovascular bundle , botulinum toxin , etiology , surgery , presentation (obstetrics) , pathology
Neurogenic thoracic outlet syndrome (NTOS) represents a disorder believed to involve compression of one or more neurovascular elements as they exit the thoracic outlet. This comprehensive literature review will focus on the occurrence, classification, etiology, clinical presentation, diagnostic measures, and both nonoperative and operative therapies for NTOS. NTOS represents the most common subtype of thoracic outlet syndrome and can significantly impair quality of life. Botulinum toxin injection into the anterior scalene muscle, or even the middle scalene or pectoralis minor muscles, can reduce the symptoms of this syndrome. The best available evidence for botulinum toxin therapy to the cervicothoracic muscles supports the value of this treatment for reducing pain in the affected extremity, and for an approximate duration of 2 months or more. Surgical approaches and newer minimally invasive surgical approaches offer high rates of improvement in select centers.