About this book
- Definitive text on thoracic outlet syndrome (TOS)
- Comprehensive resource on all clinical aspects of the condition
- Provides standardized evidence-based information on TOS topics
Thoracic outlet syndrome (TOS) is a condition estimated to affect as many as 80 of every 1000 patients in the US alone. While estimates vary widely based in part on lack of consensus as to the definition of the syndrome, as many as 3000 first rib resections are performed annually in the US. TOS comprises at least three separate conditions. The most common, neurogenic TOS, refers to the condition where the brachial plexus is compressed at the scalene triangle or retropectoral space, and is manifest as local and extremity pain and neurologic symptoms. Venous TOS refers to the situation where the subclavian vein is compressed by the structures making up the costoclavicular junction, and presents as acute or chronic venous thrombosis or injury or occasionally intermittent positional obstruction. Finally, arterial TOS refers to the situation where arterial injury occurs as the result of abnormal bony or ligamentous structures at the outlet, and presents as occlusion of or embolization from an abnormal artery in this area.
Thoracic Outlet Syndrome brings together many experts who treat this disease and are leaders in their fields. While it can certainly be read in its entirety (and should, by all who concentrate on this condition), it is designed to be a clinical reference, residing on a shelf in a busy surgical, vascular or neurologic clinic where individual chapters can be quickly referenced. As such, the chapters are thorough, but concise and useful to answer when a specific question arises in the course of daily practice.
Table of contents
General Issues Illig.- Overview of the problem.- Demographics, incidence, prevalence.- History.- Genaral anatomy.- Neurogenic TOS.- Anatomy and pathophysiology.- Patient evaluation and decision-making.- Imaging.- Electrophysiology.- Differential diagnosis.- Natural history.- Conservative treatment.- Operative decompression.- Role of the pectoralis minor.- Postoperative care, physical therapy, and rehab.- Recurrent TOS.- Pain syndromes and pain management.- Long-term outcomes.- Venous TOS.- Demographics and risk factors.- Anatomy and pathophysiology.- Patient evaluation and decision-making.- Imaging.- Nonoperative treatment and natural history.- Operative intervention.- General strategy.- Individual approaches, when and why.- Complex venous reconstruction at the thoracic outlet.- Postoperative care and long-term outcome.- Recurrent VTOS.- Controversies.- Arterial TOS TBD.- Demographics and risk factors.- Anatomy and physiology.- Patient evaluation and decision-making.- Imaging.- Nonoperative treatment and natural history.- Aneurysms.- ATOS in high-performance athletes.- Recurrent ATOS.- Collateral issues.- The patient’s perspective.- QOL evaluation.- Physical therapy for TOS.- Chronic Regional Pain Syndrome.- Investigational treatments.- Disability issues.- Medicolegal issues.- Psychologicial and psychosocial issues.- Patient resources.- Establishing a TOS practice.- Research perspectives and future directions