Neurogenic thoracic outlet syndrome associated with cervical rib.

[thoracic outlet syndrome]

A true neurogenic thoracic outlet syndrome (TOS ) associated with a cervical rib is considered extremely rare . The authors present their experience with 5 cases of true neurogenic TOS associated with a cervical rib . All patients were female and had a cervical rib confirmed radiographically pre-operatively . Average age was 34 ,8 years . Although all patients had been treated with several combinations of diverse drugs and a rehabilitation program before referral to surgery , all described their pain as intense and debilitating before surgical treatment . All patients had pre-operative electromyographic abnormalities . Patients were operated on via a supraclavicular approach and the cervical rib was resected . No intra-operative or postoperative complications were noted . Two years postoperatively , all patients mentioned improvement . However , only 2 were symptomless , and on no medication . In one patient there was significant improvement , and in the remaining 2 patients some residual pain persisted that had to be dealt with pharmacologically . All patients were able to resume their daily life activities . Recovery was poorer in the 2 patients that had been referred to surgery after a longer period of time since the beginning of symptoms .