TY - JOUR
A1 - Elshereef, Rawhya
A1 - Hashel, Jasem
A1 - Ahmed, Samar
A1 - El Shorbgy, Ashraf Ali
A1 - Farouk, Nadia
T1 - Comparison of functional outcome of early surgical intervention of neurogenic thoracic outlet syndrome with late surgical treatment
Y1 - 2013/1/1
JF - Egyptian Rheumatology and Rehabilitation
JO - Egypt Rheumatol Rehabil
SP - 33
EP - 38
VL - 40
IS - 1
UR - http://www.err.eg.net/article.asp?issn=1110-161X;year=2013;volume=40;issue=1;spage=33;epage=38;aulast=Elshereef
N2 - Aim of the work
The aim of the study was to compare the outcome of early surgical intervention in recently diagnosed cases of neurogenic thoracic outlet syndrome (NTOS) with late surgical treatment after a trial of conservative management.
Patients and methods
The study included 35 patients with NTOS (25 women and 10 men; aged 20-52 years) who were classified into two groups. Patients in the first group (15 patients) were operated upon 6 months after medical and physical therapy; patients in the second group were operated upon within 3 months of onset. All patients were
operated upon using the supraclavicular surgical approach. They were evaluated clinically and neurophysiologically and they answered the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire preoperatively and 6 months postoperatively for assessment of functional outcome.
Results
Paresthesia and pain were seen to have improved significantly in group II compared with group I. Muscle weakness was nonsignificantly less frequent in group II compared with group I. Group II showed a significantly better sensory nerve action potential of the ulnar nerve and less denervation in electromyography compared with group I.
The postoperative DASH score improved in both groups but it was less statistically significant in group I compared with group II (P<0.05 in group I and P<0.001 in group II).
Conclusion
We suggest that early surgical treatment for NTOS will improve functional disability, stop degeneration of nerves, and decrease the occurrence of muscle wasting and denervation of nerves compared with late surgery.
ER -