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A random Abstract
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Early versus Late Surgical Treatment for Neurogenic Thoracic Outlet Syndrome.
[thoracic outlet syndrome]
Objectives
.
To
compare
the
outcome
of
early
surgical
intervention
versus
late
surgical
treatment
in
cases
of
neurogenic
thoracic
outlet
syndrome
(
NTOS
)
.
Design
.
Prospective
study
.
Settings
.
Secondary
care
(
Al
-
Minia
University
Hospital
,
Egypt
)
from
2007
to
2010
.
Participants
.
Thirty
-
five
patients
of
NTOS
(
25
women
and
10
men
,
aged
20
-
52
years
)
,
were
classified
into
2
groups
.
First
group
(
20
patients
)
was
operated
within
3
months
of
the
onset
and
the
second
group
(
15
patients
)
was
operated
6
months
after
physiotherapy
.
Interventions
.
All
patients
were
operated
via
supraclavicular
surgical
approach
.
Outcomes
Measures
.
Both
groups
were
evaluated
clinically
and
,
neurophysiologically
and
answered
the
disabilities
of
the
arm
,
shoulder
,
and
hand
(
DASH
)
questionnaire
preoperatively
and
6
months
after
the
surgery
.
Results
.
Paraesthesia
,
pain
,
and
sensory
nerve
action
potential
(
SNAP
)
of
ulnar
nerve
were
significantly
improved
in
group
one
.
Muscle
weakness
and
denervation
in
electromyography
EMG
were
less
frequent
in
group
one
.
The
postoperative
DASH
score
improved
in
both
groups
but
it
was
less
significant
in
group
two
(
P
<
.
001
in
group
1
and
P
<
.
05
in
group
2
)
.
Conclusions
.
Surgical
treatment
of
NTOS
improves
functional
disability
and
stop
degeneration
of
the
nerves
.
Early
surgical
treatment
decreases
the
occurrence
of
muscle
wasting
and
denervation
of
nerves
compared
to
late
surgery
.
