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• W2023387192 abstract "Pectoralis minor tenotomy (PMT) is a potential surgical option for selected patients with neurogenic thoracic outlet syndrome (NTOS. The purpose of this study was to evaluate the effectiveness of isolated PMT as compared with supraclavicular decompression (SCD: scalenectomy, neurolysis, and first rib resection) first. Data were obtained for 200 patients undergoing operative treatment for disabling NTOS between 2008 and 2011. Patients with physical examination findings limited to the subcoracoid space were offered isolated PMT (n = 57), whereas those with scalene triangle findings were offered SCD first (n = 143). Functional outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) survey instrument. There were no significant differences (P > .05) between PMT and SCD patients with respect to age (37.1 ± 0.9 years), sex (73.0% female), side affected (52.0% right, 14.5% bilateral), presence of depression (36.0%), history of injury (53.5%), or the nature, duration, and magnitude of symptoms. Diagnostic muscle blocks were positive in 27 of 34 PMT (79.4%) patients. Mean preoperative DASH scores were similar between PMT and SCD groups (49.9 ± 3.6 vs 50.8 ± 1.6), but previous use of opiate pain medications was higher in PMT patients (45.6% vs 20.3%, P = .0004). All PMTs were conducted as outpatient procedures, whereas mean hospital stay after SCD was 4.8 ± 0.1 days. Mean DASH scores at 3 months were significantly improved after PMT (29.6 ± 4.2, P = .0005) and SCD (39.3 ± 2.3, P < .0001), but the extent of improvement in DASH scores was not significantly different between groups (32.1% ± 9.4% vs 23.9% ± 4.7%). There were also no significant differences in the proportion of patients demonstrating functional improvement (75.0% vs 73.3%) or use of opiate medications (35.1% vs 27.3%). Isolated PMT was effective treatment for NTOS in properly selected patients, demonstrating clinical and functional outcomes similar to conventional SCD. These findings support an important role for PMT in the management of NTOS." @default.
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• W2023387192 date "2012-10-01" @default.
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• W2023387192 title "Effectiveness of Isolated Pectoralis Minor Tenotomy (PMT) in Selected Patients With Neurogenic Thoracic Outlet Syndrome (NTOS)" @default.
• W2023387192 doi "https://doi.org/10.1016/j.jvs.2012.08.016" @default.
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