Neurogenic thoracic outlet syndrome is a form of thoracic outlet syndrome which occurs from compression of the brachial plexus.
Neurogenic thoracic outlet syndrome is a form of thoracic outlet syndrome which occurs from compression of the brachial plexus. There are some similarities and differences between vascular and neurogenic thoracic outlet syndrome, but both require a high index of suspicion. Neurogenic thoracic outlet syndrome, sometimes called nTOS, account for up to 95 percent of cases of TOS.
It is the second most discussed nerve compression entrapment syndrome following carpal tunnel syndrome. This is a clinical diagnosis that describes symptomatic manifestation of compression of the brachial plexus as it traverses through the thoracic outlet. It continues to remain somewhat controversial due to it being largely subjective in nature.
There have been recent developments in diagnostic studies that have allowed for more clearly-defined guidelines. The brachial plexus trunks or cords, which originate from nerve roots C5 to T1, are the areas that are compressed during TOS. The areas of compression are the same as vascular TOS covered previously.
Neurogenic TOS affects around 1-2 % of the population, is more common in women (about 3:1 ratio) and tends to be unilateral. The age range most affected is 20-60, although cases have been reported in children at age 10. The lower brachial plexus is affected in about 80 percent of patients.
Some will divide neurogenic TOS into true and disputed nTOS with the โtrueโ TOS with nerve conduction slowing or needle electromyography changes. Etiologies are similar in all variations of thoracic outlet syndrome as well. Anatomical abnormalities such as cervical or rudimentary first ribs have been shown to be more common in patients that suffer with symptoms of TOS (29 percent vs 1.1 percent).
If you are experiencing symptoms that may be related to neurogenic thoracic outlet syndrome, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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