scholarly journals VESS21. Reoperation for Recurrent Neurogenic Thoracic Outlet Syndrome Is Effective in Achieving Symptomatic and Functional Improvement Following Surgical Decompression

2019 ◽  
Vol 69 (6) ◽  
pp. e68-e69
Author(s):  
Sasha Still ◽  
Lauren Beliveau ◽  
Jose Iglesias ◽  
Jessica Clothier ◽  
Kristen Tecson ◽  
...  
Keyword(s):  
Thoracic Outlet Syndrome ◽  
Surgical Decompression ◽  
Functional Improvement ◽  
Neurogenic Thoracic Outlet Syndrome

Anatomically Complete Supraclavicular Reoperation for Recurrent Neurogenic Thoracic Outlet Syndrome: Clinical Characteristics, Operative Findings, and Long-term Outcomes

Hand ◽  
2021 ◽  
pp. 155894472098807
Author(s):  
Momodou L. Jammeh ◽  
J. Westley Ohman ◽  
Chandu Vemuri ◽  
Ahmmad A. Abuirqeba ◽  
Robert W. Thompson
Keyword(s):  
Thoracic Outlet Syndrome ◽  
Length Of Hospital Stay ◽  
Functional Improvement ◽  
Scalene Muscle ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
First Rib ◽  
Previous Operation ◽  
Combined Operations ◽  
The Mean ◽  
Operative Findings

Background: The clinical outcomes of reoperations for recurrent neurogenic thoracic outlet syndrome (NTOS) remain undefined. Methods: From 2009 to 2019, 90 patients with recurrent NTOS underwent anatomically complete supraclavicular reoperation after previous operation(s) performed at other institutions using either supraclavicular (Prev-SC = 48), transaxillary (Prev-TA = 31), or multiple/combination (Prev-MC = 11) approaches. Prospectively maintained data were analyzed retrospectively. Results: The mean patient age was 39.9 ± 1.4 years, 72% were female, and the mean interval after previous operation was 4.1 ± 0.6 years. The mean Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score was 62 ± 2, reflecting substantial preoperative disability. Residual scalene muscle was present in 100% Prev-TA, 79% Prev-SC, and 55% Prev-MC ( P < .05). Retained/residual first rib was present in 90% Prev-TA, 75% Prev-SC, and 55% Prev-MC ( P < .05). There were no differences in operative time (overall 210 ± 5 minutes), length of hospital stay (4.7 ± 0.2 days), or 30-day readmissions (7%). During follow-up of 5.6 ± 0.3 years, the improvement in QuickDASH scores was 21 ± 2 (36% ± 3%) ( P < .01) and patient-rated outcomes were excellent in 10%, good in 36%, fair in 43%, and poor in 11%. Conclusions: Anatomically complete decompression for recurrent NTOS can be safely and effectively accomplished by supraclavicular reoperation, regardless of the type of previous operation. Residual scalene muscle and retained/residual first rib are more frequently encountered after transaxillary operations than after supraclavicular or multiple/combined operations. Supraclavicular reoperation can achieve significant symptom reduction and functional improvement for approximately 90% of patients with recurrent NTOS.

scholarly journals A Clinicoradiological Assessment following Surgical Intervention in Patients of Cervical Spondylotic Myelopathy: An Institutional Experience

2021 ◽  
Author(s):  
Maneet Gill ◽  
Vikas Maheshwari ◽  
Arun Kumar Yadav ◽  
Rushikesh Gadhavi
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Surgical Intervention ◽  
Japanese Orthopaedic Association ◽  
Surgical Decompression ◽  
Functional Improvement ◽  
Male Predominance ◽  
Canal Diameter ◽  
Posterior Group

Abstract Introduction  To critically analyze the functional and radiological improvement in patients of cervical spondylotic myelopathy (CSM) who underwent surgical decompression by an anterior or posterior approach. Materials and Methods  A retrospective study was conducted in a tertiary-level Armed Forces Hospital from June 2015 to December 2019. Preoperative assessment included a thorough clinical examination and functional and radiological assessment. The surgical decompression was done by an anterior or a posterior approach with instrumented fusion. Anterior approach was taken for single or two-level involvement and posterior approach for three or more cervical levels. The pre and postoperative neurological outcome was assessed by Nurick and modified Japanese Orthopaedic Association (mJOA) score along with measurement of canal diameter and cross-sectional area. Results  A total of 120 patients of CSM who underwent surgical decompression were analyzed. Both the groups were comparable and had male predominance. A total of 59 patients underwent surgical decompression by an anterior approach and the remaining 61 patients by the posterior approach. Out of the 59 patients operated by the anterior approach, 30 (50.85%) underwent anterior cervical discectomy and fusion (ACDF); remaining 29 (49.15%) underwent anterior cervical corpectomy and fusion (ACCF). In the posterior group (n = 61), 26 (42.6%) patients underwent laminoplasty and the remaining 35 (57.4%) underwent laminectomy with or without instrument fusion. Sixteen patients out of these underwent lateral mass fixation and the remaining 19 underwent laminectomy. There was functional improvement (mJOA and Nurick grade) and radiological improvement in both subgroups, which were statistically significant (p < 0.0001). Conclusion  A prompt surgical intervention in moderate-to-severe cases of CSM either by the anterior or the posterior approach is essential for good outcome.

scholarly journals Computed tomography-guided reoperation for neurogenic thoracic outlet syndrome

2015 ◽  
Vol 61 (2) ◽  
pp. 469-474 ◽  
Author(s):  
Joshua I. Greenberg ◽  
Kristen Alix ◽  
Mark R. Nehler ◽  
Robert J. Johnston ◽  
Charles O. Brantigan
Keyword(s):  
Computed Tomography ◽  
Thoracic Outlet Syndrome ◽  
Neurogenic Thoracic Outlet Syndrome

Diagnosis of Neurogenic Thoracic Outlet Syndrome Based on the Clinical Status

2021 ◽  
Author(s):  
Ji Sup Hwang ◽  
Jihyeung Kim ◽  
Shin Kim ◽  
Kee Jeong Bae ◽  
Yohan Lee ◽  
...  
Keyword(s):  
Thoracic Outlet Syndrome ◽  
Clinical Status ◽  
Neurogenic Thoracic Outlet Syndrome
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