Thoracic outlet syndrome due to hyperextension-hyperflexion cervical injury
Book Series Acta Neurochirurgica Supplements
Volume Volume 97
Book Advanced Peripheral Nerve Surgery and Minimal Invasive Spinal Surgery
Publisher Springer Vienna
DOI 10.1007/b139101
Copyright 2005
ISBN 978-3-211-23368-9 (Print) 978-3-211-27458-3 (Online)
Part Part I:
DOI 10.1007/3-211-27458-8_5
Pages 21-24
Subject Collection Medicine
SpringerLink Date Friday, June 23, 2006
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Acta Neurochirurgica
Advanced Peripheral Nerve Surgery and Minimal Invasive Spinal Surgery
10.1007/3-211-27458-8_5
H.-J. Steiger, Alberto Alexandre, Albino Bricolo and Hanno Millesi
5. Thoracic outlet syndrome due to hyperextension-hyperflexion cervical injury
Alberto Alexandre4 Contact Information, L. Corņ4, A. Azuelos4 and M. Pellone4
(4) EU.N.I. European Neurosurgical Institute, Treviso, Italy
(5) EU.N.I. European Neurosurgical Institute, Via Ghirada 2, 31100 Treviso, Italy
Summary
Posttraumatic brachial plexus entrapment in fibrotic scarring tissue is taken into consideration as the cause of complaints for patients who suffered a hyperextension-hyperflexion cervical injury. All 54 patients included in this analysis where symptom-free before the accident and subsequently complained for pain, paresthesia and slight weakness in the arm. In 14 neurological signs of brachial plexus entrapment were observed. Electroneurophysiological, summary index testing was positive for a brachial plexus involvement in all cases. Conservative measures, comprising physical therapy and vasoactive drugs were applied for a period of 6 to 12 (mean 8.4) months; surgical procedure of neurolysis was then proposed in 39 cases to solve the problem. Thirty-two patients were operated on. Twenty of these had a neat improvement on a 6-month to 1-year follow-up. Seven patients had refused surgery; of these 6 patients had clinical worsening at the same follow-up period while 1 remained unchanged. All patients with clinical symptoms not reversed after some time post-injury should be investigated for a possible brachial plexus entrapment.
Keywords Brachail plexus - entrapment - thoracic outlet - hyper-flexion - hyperextension - whiplash injury
http://www.springerlink.com/content/j1204042u0755433/