Table of Contents
ISRN Neurology
Volume 2013, Article ID 673020, 6 pages
Clinical Study

Early versus Late Surgical Treatment for Neurogenic Thoracic Outlet Syndrome

1Department of Neurology, Ibn Sina Hospital, P.O. Box 25427, Safat 13115, Kuwait
2Department of Medicine, Kuwait University, P.O. Box 24923, Safat 13110, Kuwait
3Department of Cardiothoracic Surgery, Minia University, P.O. Box 61519, Minia 61111, Egypt
4Department of Neurology and Psychiatry, Minia University, P.O. Box 61519, Minia 61111, Egypt
5Department of Rheumatology, Minia University, P.O. Box 61519, Minia 61111, Egypt

Received 1 July 2013; Accepted 6 August 2013

Academic Editors: T. Hori and W. Lüdemann

Copyright © 2013 Jasem Yousef Al-Hashel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To compare the outcome of early surgical intervention versus late surgical treatment in cases of neurogenic thoracic outlet syndrome (NTOS). Design. Prospective study. Settings. Secondary care (Al-Minia University Hospital, Egypt) from 2007 to 2010. Participants. Thirty-five patients of NTOS (25 women and 10 men, aged 20–52 years), were classified into 2 groups. First group (20 patients) was operated within 3 months of the onset and the second group (15 patients) was operated 6 months after physiotherapy. Interventions. All patients were operated via supraclavicular surgical approach. Outcomes Measures. Both groups were evaluated clinically and, neurophysiologically and answered the disabilities of the arm, shoulder, and hand (DASH) questionnaire preoperatively and 6 months after the surgery. Results. Paraesthesia, pain, and sensory nerve action potential (SNAP) of ulnar nerve were significantly improved in group one. Muscle weakness and denervation in electromyography EMG were less frequent in group one. The postoperative DASH score improved in both groups but it was less significant in group two ( in group 1 and in group 2). Conclusions. Surgical treatment of NTOS improves functional disability and stop degeneration of the nerves. Early surgical treatment decreases the occurrence of muscle wasting and denervation of nerves compared to late surgery.