Information: Thoracic Outlet Syndrome from Fibrous Band on the Lower Trunk of the Brachial Plexus
Slideshow:Image evaluation of thoracic outlet syndrome.
A 52-year-old woman presenting with a two-year history of right 4th and 5th digit pain and negative EMG/NCV of the ulnar nerve at elbow and wrist, who has no cervical disc disease. The preoperative Neurography (Pre-Op) shows a kink distorting the course of the lower trunk of the brachial plexus. The diagram identifies the anatomy and shows a fibrous band extending from the C7 transverse process to the first rib that causes the image finding.
After a supraclavicular approach for resection of the anterior scalene and neurolysis of the lower trunk, the patient experienced complete relief of right hand and arm symptoms, now maintained at nearly two years follow-up. The postoperative and contralateral images from the same patient show the mechanical result of the surgery in restoring normal anatomy.