Outcomes after surgery for thoracic outlet syndrome

David A. Axelrod, Mary C. Proctor, Michael E. Geisser, Randy S. Roth, Lazar J. Greenfield

Research output: Contribution to journalArticlepeer-review

82 Scopus citations

Abstract

Purpose: This study determined whether there is an association between psychological and socioeconomic characteristics and the long-term outcome of operative treatment for patients with sensory neurogenic thoracic outlet syndrome (N-TOS). Methods: Clinical records, preoperative psychological testing results, and long-term follow-up questionnaire data were reviewed for consecutive patients who underwent surgery for N-TOS from 1990 to 1999. Multivariate logistic regression models were developed as a means of identifying independent risk factors for postoperative disability. Results: Operative decompression of the brachial plexus via a supraclavicular approach was performed for upper extremity pain and paresthesia with no mortality and minimal morbidity in 170 patients. After an average follow-up period of 47 months, 65% of patients reported unproved symptoms, and 64% of patients were satisfied with their operative outcome. However, 35% of patients remained on medication, and 18% of patients were disabled. Preoperative factors associated with persistent disability include major depression (odds ratio [OR], 15.7; P = .02), not being married (OR, 7.9; P = .04), and having less than a high school education (OR, 8.1; P = .09). Conclusion: Operative decompression was beneficial for most patients. Psychological and social factors, including depression, marital status, and education, are associated with self-reported disability. The impact of the preoperative treatment of depression on the outcome of TOS decompression should be studied prospectively.

Original languageEnglish (US)
Pages (from-to)1220-1225
Number of pages6
JournalJournal of Vascular Surgery
Volume33
Issue number6
DOIs
StatePublished - Jun 2001

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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