Thoracic outlet syndrome: evaluation of clinical features and long-term outcomes after scalenotomy

Background: Thoracic outlet syndrome (TOS) is a very complicated and diverse pathology including a range of symptoms related to the upper limb, neck, head, and other symptoms. This study was aimed to evaluate the long-term results of anterior scalenotomy in patients with TOS. Methods: We examined patients that were operated on 2007–2011. The rate of symptoms was evaluated from medical records. Changes in pain, tactile sensation, strength of a handgrip, muscle wasting and patient’s satisfaction were evaluated postoperatively. Results: Seventy-seven patients returned to follow-up evaluation (23 patients were treated for bilateral plexopathy). The mean follow-up was 50.3 months. Preoperative complaints (%) were as follows: upper extremity pain (93.0), numbness/paresthesia (93.7), decrease in hand strength (90.0) and headaches (53.8). Postoperatively, upper extremity pain disappeared in 81.7, numbness in 86.7 and headaches in 42.9 % of cases. Hand strength increased from 16.1 to 19.68 kg on average. Patients’ satisfaction with the results was evaluated as (%) follows: excellent (50.0), good (33.0), fair (15.0) and poor (2.0). Conclusions: Anterior scalenotomy is an effective operative method to treat TOS. Level of Evidence: Level IV, therapeutic study. © 2017, Springer-Verlag Berlin Heidelberg.