2025 ISAKOS Biennial Congress ePoster
All-Endoscopic Release Of The Brachial Plexus In Neurogenic Thoracic Outlet Syndrome. Early Results Of A Prospective Case Series.
Freek Hollman, MD, PhD, Venlo NETHERLANDS
Jose Carlos Garcia Jr., MD, PhD, Sao Paulo, SP BRAZIL
Esther Janssen, PhD, Venlo NETHERLANDS
Okke Lambers Heerspink, MD, PhD, Venlo NETHERLANDS
VieCuri Medical Center, Venlo, NETHERLANDS
FDA Status Not Applicable
Summary
Early results show that all-endoscopic release of the brachial plexus in neurogenic thoracic outlet syndrome is a safe and promising procedure with good clinical results
ePosters will be available shortly before Congress
Abstract
Introduction
Neurogenic thoracic outlet syndrome (nTOS) is still a debilitating condition with ongoing discussions on its existence and developments on treatment algorithms and surgical techniques. Several endoscopic techniques are described although more clinical results of these techniques are needed to prove its superiority as compared to open alternatives. In this study short term results of all-endoscopic brachial plexus release in nTOS are presented.
Methods
Between August 2023 and May 2024 6 consecutive patients with clinically suspected nTOS based on an affective intramuscular pectoralis minor block and clinical findings, failed conservative treatment and consensus of the presence of an orthopedic shoulder surgeon, neurologist and physiotherapist were indicated for surgery.
All patients underwent endoscopic release is a standardized technique including, release of the pectoralis minor and subclavian muscle and release of any fibrotic cords around the plexus up to the level of the trunci and division of the suprascapular nerve.
Results
Mean age at surgery was 42 years (range 21-58) and male:female ratio 4:2. At baseline and 6 weeks postoperative the TOS disability index, Cervical Brachial Symptom Questionnaire (CBSQ) and Quick Disabilities of the Arm, Shoulder and Hand (DASH) were obtained and improved on average from 6.2 to 2.8, 62.3 to 27.5 and 60.2 to 29.7.
No early complications were observed.
Conclusion
In conclusion, early results show that all-endoscopic release of the brachial plexus in neurogenic thoracic outlet syndrome is a safe and promising procedure with good clinical results.