Neurogenic thoracic outlet syndrome associated with cervical rib.

Gerardo Millan, Diogo Casal, Amets Sagaribay, Valdemar Marques, J. Estrela Martins

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A true neurogenic thoracic outlet syndrome (TOS) associated with a cervical rib is considered extremely rare. The authors present their experience with 5 cases of true neurogenic TOS associated with a cervical rib. All patients were female and had a cervical rib confirmed radiographically pre-operatively. Average age was 34,8 years. Although all patients had been treated with several combinations of diverse drugs and a rehabilitation program before referral to surgery, all described their pain as intense and debilitating before surgical treatment. All patients had pre-operative electromyographic abnormalities. Patients were operated on via a supraclavicular approach and the cervical rib was resected. No intra-operative or postoperative complications were noted. Two years postoperatively, all patients mentioned improvement. However, only 2 were symptomless, and on no medication. In one patient there was significant improvement, and in the remaining 2 patients some residual pain persisted that had to be dealt with pharmacologically. All patients were able to resume their daily life activities. Recovery was poorer in the 2 patients that had been referred to surgery after a longer period of time since the beginning of symptoms.

Original languageEnglish
Pages (from-to)98-103
Number of pages6
JournalActa Reumatológica Portuguesa
Issue number2
Publication statusPublished - Apr 2013


  • Thoracic outlet syndrome
  • Brachial plexus
  • Cervical rib
  • Nerve compression syndrome
  • Surgery


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