Turkish Neurosurgery 1999 , Vol 9 , Num 3-4
Serhat ERBAYRAKTAR, Engin UÇAR, Burak SADE, Ümit ACAR, Metin GÜNER
Dokuz Eylül University, School of Medicine, Department of Neurosurgery İzmir, Turkey The characteristics of neurogenic thorasic outlet syndrome due to compressions at the interscalene triangle were evaluated in 17 patients. Sixteen of the patients were female, and the mean age of the group was 34,6 years. Eight cases had only osseous anomalies (Group I). Another six had no bony variations, and the scalene muscles had caused the compression (Group II). The other 3 cases had both bony anomalies and muscular compression (Group III). The most common symptoms were painful myofascitis (88%) and paresthesia (77%), and the most frequent physical findings were motor deficits (82%) and positive Adson's tests (82%). In cases with osseous anomalies cervicocephalic symptoms were often seen but paresthesia was relatively rare (p<0.05). AIso in these patients, a positive hyperadduction test was often accompanied by a fibrous band. Double crush or reverse double crush syndromes were detected in 7 of the 17 cases. Of the electrophysiological tests performed, electromyography gave the most information. Twenty-one extremities in 17 patients were operated via a supradavicular appproach sparing the first rib, and no complications were encountered. Fibrous bands were found only in patients who had osseous anomalies (p<0.05). Satisfactory and tolerable results were achieved in nine (53%) and seven (41 %) patients, respectively. Keywords : Double crush syndrome, supradavicular approach, thoracic outlet syndrome
Corresponding author : Serhat Erbayraktar