Transaxillary First Rib Resection and Partial Scalenectomy for Neurogenic Thoracic Outlet Syndrome

Abstract

Neurogenic thoracic outlet syndrome typically presents with paresthesia, pain, and impaired strength in the neck, shoulder, and arm, and is typically a diagnosis of exclusion. This condition is caused by compression of the brachial plexus, typically by a bony or soft tissue anomaly present congenitally and influenced by repetitive motion or significant trauma. Treatment typically involves removal of the first rib and anterior scalene to decompress the thoracic outlet and relieve stress to the brachial plexus if the patient has failed conservative treatment with physical therapy and lifestyle modifications. We present a case of neurogenic thoracic outlet syndrome treated surgically via a transaxillary first rib resection.