LONG-TERM OUTCOME OF SURGERY FOR THORACIC OUTLET SYNDROME

BACKGROUND: Thoracic outlet syndrome (TOS) is one of the most controve rsial symptom complexes in surgery today. Even the existence of TOS is questioned and where it seems to exist, the incidence varies from one country to another. Surgery is often considered the primary treatment ; however, the frequency of good results after surgery varies from 24% to 100%, and in recent years the surgical approach has been questione d. PATIENTS AND METHODS: In this study 45 patients who had undergone s urgery for TOS symptoms period of 21 years were examined by an indepen dent clinician an average of 8 years after the operation. RESULTS: For ty-three percent of the performed operations were found to have been s uccessful. Preoperative nocturnal and neck pain were more frequent in the unsuccessful group; no other preoperative characteristics had a pr edictive value. Preoperative radiographic and neurophysiologic examina tions were also not predictive of the outcome. CONCLUSION: It is recom mended that the feasibility of conservative therapeutic approaches sho uld be evaluated before undertaking surgery for TOS symptoms.