LONG-TERM RESULTS OF PRIMARY SCALENOTOMY IN THE TREATMENT OF THORACICOUTLET SYNDROME

A total of 107 patients with thoracic outlet syndrome were reviewed an average of 4.1 years (range 2-11 years) after primary scalenotomy. Th e sample included 86 women and 21 men, and the mean age at surgery was 41.9 years (range 16-59 years). The three most disturbing pre-operati ve symptoms were pain at rest (87%), numbness (66%) and lack of power (55%). The post-operative success rate diminished from 71% 1 month aft er operation to 63% at follow-up. The retirement frequency increased f rom 6% up to 33% during the follow-up time. It was highest among facto ry workers at 60%. Of the patients older than 45 years at surgery, 68% were retired at follow-up. The importance of careful selection for op eration is emphasized, and also the need to consider vocational rehabi litation before resorting to surgical treatment of thoracic outlet syn drome. We recommend surgical treatment for this disabling disorder, es pecially for younger patients with clear evidence of thoracic outlet s yndrome who are engaged in occupations demanding little repetitive wor k. The best results have occurred in this group.