Nerve.  2023 Apr;9(1):85-89. 10.21129/nerve.2023.00318.

Neurogenic Thoracic Outlet Syndrome Induced by Subclavius Muscle Hypertrophy: A Case Report

• Ha J
• Lee S
• Beak J
• Ryou KS
• Park TJ
• Kim SH

• KMID: 2543265
• DOI: http://doi.org/10.21129/nerve.2023.00318

Abstract

Neurogenic thoracic outlet syndrome (NTOS) is a complex disorder characterized by compression of the brachial plexus, resulting in pain, weakness, and sensory changes in the upper extremity. Traditional surgical treatments, such as first rib resection or anterior scalene muscle resection, can be invasive and associated with significant morbidity. We present a unique case of a patient diagnosed with NTOS who underwent a preoperative magnetic resonance imaging with the shoulder in an abduction position to identify the cause of NTOS. A minimally invasive subclavius muscle resection was subsequently performed, resulting in a dramatic reduction in pain and significant improvement in motor symptoms. This less invasive approach led to a quicker recovery time and reduced morbidity compared to traditional surgical methods. This case report suggests that before surgery, thoroughly investigating the causes of NTOS and selectively performing decompression only on the structures requiring intervention could also be considered a viable treatment option.

Keyword

Thoracic outlet syndrome; Neurogenic thoracic outlet syndrome; Brachial plexus; Subclavius muscle resection; Subclavius muscle hypertrophy