Thoracic Outlet Syndrome & Cervical Rib

The result from compression of the nerves or blood vessels that serve your arms. Usually affects otherwise healthy, young and active people.

One of the common reasons is having an extra bone coming from the spine-this is called a Cervical Rib. This extra bone narrows the already limited space in the vase of the neck resulting in damage to the structures passing through that area. The structures include the main blood vessels carrying blood to and from your arm and part of the brain and all the nerves to your shoulder, arm and hands.

Symptoms

Pain, numbness, tingling

Swelling, blue discolouration, fatigue of arms and hands

Non-healing wounds

Thoracic Outlet

Causes

  • Compression of nerves, the subclavian artery or subclavian vein on the side of the throat or upper chest
  • Injury to the artery due to an abnormality in a neck rib or other bony irritation
  • Injury or compression of the vein. This could lead to a progressive narrowing of the vessel and eventual clot formation.
Thoracic Outlet

Diagnosis

Several tests are used to detect thoracic outlet syndrome:

  • Computed tomography (CT) scan
  • Magnetic resonance imagining (MRI)

  • Catheter-based arteriography or venogram
  • Stress manoeuvre testing—placing the arm or head in certain positions—may be done with any of the above tests.

Treatments

Depends on the primary target – artery, vein or nerve

NERVE-RELATED
  • Specialized physical therapy is the first line of treatment
  • If symptoms are severe and persist and you are a good candidate for surgery, a procedure called thoracic outlet decompression is the next step.
  • If surgery is not suitable for you or does not relieve your symptoms, you will want to consider ongoing medication to manage pain.
ARTERY-RELATED
  • If arterial compression is diagnosed, a surgery called thoracic outlet decompression is the next step. Depending on the damage to the artery, an arterial reconstruction may be part of this surgery.
VEIN-RELATED
  • If arm swelling or a blood clot in the vein is due to thoracic outlet compression, thoracic outlet decompression is the next step.
  • If there is a clot in the vein, you may be directed to have thrombolytic therapy.
  • You may also benefit from some type of vein reconstruction: angioplasty/stenting, patch angioplasty, or venous bypass.

Health tips 

Maintain a healthy diet and lifestyle, including physical activity.

Copyright 2021 - Vascular Surgeon Bangalore