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

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OBJECTIVE: The efficacy of brachial plexus decompression through a supraclavicular approach for neurogenic thoracic outlet syndrome (TOS) and its impact on surgical outcomes were investigated. METHODS: The 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. RESULTS: At 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. CONCLUSION: Brachial plexus decompression through a supraclavicular approach proved effective in alleviating pain and functional disability in patients with neurogenic TOS.