Relation between Brachial Plexus Stretching Type of Thoracic Outlet Syndrome and Lateral View of Cervical Spine X-rays.

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We have reported that thoracis outlet syndrome (TOS) results not only from neurovascular compression but also from stretching and defined any such patients as brachial plexus stretching type of TOS. In 1984, T. R. Swift described that droopy shoulder syndrome (DSS) also results from brachial plexus stretching, and that in all patients with DSS, because of their characteristic features, the second thoracic or lower vertebrae visible above their shoulders on lateral view of cervical spine X-rays are one of the diagnostic criteria for DSS. Therefore, we studied the relationship between brachial plexus stretching and the lateral view of cervical spine X-rays.We examined 40 cases with brachial plexus stretching type of TOS from 1990 to 1993, in whom a neurography of the brachial plexus had been carried out. In 18 cases, 45% of them, lateral view of cervical spine X-rays demonstrated that the secone thoracic or lower vertebrae was above the level of the shoulders. Patients with brachial plexus stretching type of TOS had a "long neck". In 1990 Y. Kataoka reported that all patients whose second thoracic or lower vertebrae were visible above their shoulders on lateral view of cervical spine X-rays had no symptoms induced by brachial plexus stretch. We found that this finding on X-rays did not always represent brachial plexus stretching and its symptoms.
西日本整形・災害外科学会の論文