Libération endoscopique du plexus brachial dans les syndromes du défilé thoraco-brachial : à propos de 36 cas au recul moyen de 18 mois

Abstract : Introduction : new techniques are developing in the surgical treatment of thoracic outlet syndromes (TOS), especially endoscopic ones. The object of our study is to evaluate the clinical and functional outcomes of endoscopic treatment of TOS. Material and methods: a retrospective review was conducted, including all patients undergoing endoscopic brachial plexus release for TOS between 2015 and 2017. 33 patients (36 cases) were reviewed with a mean age of 41.4 years at a mean follow-up of 18.7 months. 2,8% of cases had a neurogenic TOS presentation, 50% vascular and 47,2% combined. The clinical results were evaluated as well as the QuickDASH and the Cervical Brachial Symptoms Questionnaire (CBSQ) functional scores performed preoperatively and at the last follow-up. Positive symptoms or maneuvers were searched as well as all complications and surgical revisions. Results : the results were excellent or good in 75,6% of cases. QuickDASH and CBSQ were significantly improved from 63,5 to 43,2 and from 85,1 to 45,3, respectively. The pains had disappeared in 72,2% of cases and paresthesia in 86,1%. 7 patients had a recurrence of the symptomatology, 5 of which required surgical revision. Conclusion: endoscopic decompression of TOS is a safe technique that gives good clinical results, but should be reserved in vascular forms for distal compressions without endovascular or bone abnormalities. Clinical and anatomical studies are necessary to better target its indications. Level of evidence : level IV, cases series.
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Master Thesis
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Youssouf Tanwin. Libération endoscopique du plexus brachial dans les syndromes du défilé thoraco-brachial : à propos de 36 cas au recul moyen de 18 mois. Chirurgie. 2018. ⟨dumas-02075130⟩

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