Thoracic outlet syndrome.

ider clinical recognition of the thoracic outlet syndrome may be attributed to improved methods of diagnosis and W therapy. Compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax has been previously designated according to the presumed etiologies such as cervical rib, scalenus anticus, costoclavicular, hyperabduction, and first thoracic rib syndromes. Because the various syndromes are similar and the specific compression mechanism is often difficult to identify, grouping of these syndromes under the term neurovascular compression, shoulder girdle, or thoracic outlet syndrome, as suggested by Rob and Standoven [ Z O ] in 1958, seems more appropriate. In severe or refractory cases, resection of the first thoracic rib, with a cervical rib or long transverse process of the seventh cervical and first thoracic vertebras when present, removes the common denominator against which most of the difficult-to-separate compressive factors operate and provides the most efficacious therapy [6, 10, 161. An analysis of 120 patients with thoracic outlet syndrome has been