Pain and Functional Outcome of Supraclavicular Decompression of the Brachial Plexus for Neurogenic Thoracic Outlet Syndrome.

ObjectiveThe efficacy of brachial plexus decompression through a supraclavicular approach for neurogenic thoracic outlet syndrome (TOS) and its impact on surgical outcomes were investigated.MethodsThe outcomes of pain reduction and functional improvement were evaluated in 31 patients with neurogenic TOS who underwent a supraclavicular decompression. These patients were followed for at least 12 months. Pain reduction was quantified using a numerical rating scale-11 (NRS-11) score and percentage pain relief before and after the last follow-up. Functional and symptomatic outcomes were assessed using the QuickDASH (Disability of the Arm, Shoulder, and Hand 11-item version) questionnaire, and changes in functional disability were measured by the percentage change in QuickDASH scores. Success was defined as at least a 50% reduction in pain as measured by the NRS-11, and factors influencing surgical success were also explored.ResultsAt a follow-up of 31.7±11.7 months, supraclavicular brachial plexus decompression was successful in 24 of 31 patients (77.4%), with a mean pain relief rate of 54.3±29.0. Functional outcomes assessed by QuickDASH scores improved significantly (from 52.7±12.6 to 23.6±17.9), with a percentage reduction of 56.36±31.56. There were no neurological complications associated with the surgery, although one reoperation was required due to postoperative chyle leakage.ConclusionBrachial plexus decompression through a supraclavicular approach proved effective in alleviating pain and functional disability in patients with neurogenic TOS.