Conservative Treatment for Thoracic Outlet Syndrome. Management of Brachial Plexus Stretching Type of TOS.:—Management of Brachial Plexus Stretching Type of TOS—

概要

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It has been thought that the underlying mechanism of thoracic outlet syndrome (TOS) was compression of the neurovascular bundle at the thoracic outlet. In recent years, however, it has been confirmed that not only compression but also stretching of the brachial plexus constitute the underlying pathophysiology of TOS. We classified TOS into compression type and stretching type using neurography of the brachial plexus and clinical findings. These types of TOS were separately managed.<BR>Conservative treatment should be the first choice of treatment for all patients with TOS, which includes correcting the posture and strengthening the shoulder girdle muscles with an orthosis stabilizing scapula (Kumamoto University scapular band) . Emphasis was placed on alleviation of brachial plexus irritation due to its stretching. Based on our experience, thoracic outlet decompression operation and cervical traction were contraindications for the stretching type of TOS.<BR>We believe that the appropriate conservative treatment adapted to the different conditions, compression and stretching, leads to good results.
日本関節病学会の論文