Thoracic Outlet Syndrome - 07/08/11

Doi : 10.1016/j.pmr.2011.02.010

Glenn Ozoa, DO ^a,^⁎ , Daniel Alves, MD ^b, David E. Fish, MD, MPH ^c,^d
^a Beverly Hills Orthopedic Group, 120 South Spalding Drive, Suite 401, Beverly Hills, CA 90212, USA
^b Universal Pain Management, Los Angeles, CA, USA
^c Division of Interventional Physiatry, Physical Medicine and Rehabiliation, The UCLA Spine Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
^d Department of Orthopaedics, Physical Medicine and Rehabiliation, The UCLA Spine Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

Corresponding author.

Résumé

Of the many clinical entities involving the neck region, one of the most intriguing is thoracic outlet syndrome (TOS). TOS is an array of disorders that involves injury to the neurovascular structures in the cervicobrachial region. A classification system based on etiology, symptoms, clinical presentation, and anatomy is supported by most physicians. The first type of TOS is vascular, involving compression of either the subclavian artery or vein. The second type is true neurogenic TOS, which involves injury to the brachial plexus. Finally, the third and most controversial type is referred to as disputed neurogenic TOS. This article aims to provide the reader some understanding of the pathophysiology, workup, and treatment of this fascinating clinical entity.

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Keywords : Thoracic outlet syndrome, Neurogenic TOS, Vascular TOS, Disputed TOS, Interscalene triangle, Costoclavicular triangle, Subpectorialis minor space