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[PMID]:27989967
[Au] Autor:Abdel Ghany W; Nada MA; Toubar AF; Desoky AE; Ibrahim H; Nassef MA; Mahran MG
[Ad] Endereço:Department of Neurosurgery, Ain Shams University, Abbasseya, Cairo, Egypt. Electronic address: wghany@gmail.com.
[Ti] Título:Modified Interscalene Approach for Resection of Symptomatic Cervical Rib: Anatomic Review and Clinical Study.
[So] Source:World Neurosurg;98:124-131, 2017 Feb.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cervical ribs have been reported to be present in about 0.5% of the general population, 10% of patients with cervical rib who are symptomatic usually have neurogenic symptoms, but some have arterial symptoms. In 1861, Coote was the first to excise a cervical rib through a supraclavicular approach and relieved the symptoms of thoracic outlet syndrome. OBJECTIVE: In this study, we address the efficacy and safety of a modification to the supraclavicular approach for resection of symptomatic cervical ribs. PATIENTS AND METHODS: The surgical team in collaboration with an anatomist performed cadaveric dissections of the posterior triangle of the neck in the Department of Anatomy, Ain Shams University. A prospective study was performed of 25 patients with moderate to severe neck or upper limb pain; this pain was resistant to medical treatment for at least 6 months. Preoperative cervical radiography showed cervical ribs. Pain was assessed by using the visual analog scale. Electrophysiologic tests were performed to confirm the diagnosis. In this study, we performed a modified supraclavicular interscalene approach with resection of the symptomatic rib and without resecting either of the scalene muscles or the first thoracic rib. RESULTS: A total of 25 patients were included in this study; the mean age was 36 years (± 12 standard deviation), and the mean follow-up period was 12.3 months. All patients had moderate (28%) to severe (72%) preoperative pain. Motor deficits were present in 6 cases (24%); Sensory manifestations were present in 80%. All patients had a relief of severe pain at the first postoperative visit in the first week. There were improvements in the motor power in 5 of the 6 patients who had preoperative motor deficit. CONCLUSIONS: A modified supraclavicular interscalene approach for resection of symptomatic cervical ribs has been shown to be effective in the treatment of neuralgic pain. Compared with other approaches, it proved to be less invasive, with small transverse incision and without resection of scalenus anterior muscle.
[Mh] Termos MeSH primário: Medula Cervical/cirurgia
Síndrome da Costela Cervical/cirurgia
Costela Cervical/cirurgia
Descompressão Cirúrgica/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Síndrome da Costela Cervical/diagnóstico por imagem
Feminino
Seres Humanos
Imagem Tridimensional
Masculino
Meia-Idade
Estudos Prospectivos
Reoperação
Tomógrafos Computadorizados
Resultado do Tratamento
Escala Visual Analógica
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170915
[Lr] Data última revisão:
170915
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161220
[St] Status:MEDLINE


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[PMID]:26233638
[Au] Autor:Kalchiem-Dekel O; Davidesko S; Maimon N
[Ad] Endereço:Department of Medicine B, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: kalchiem@bgu.ac.il.
[Ti] Título:A 64-year old woman with right hand swelling and paresthesia.
[So] Source:Eur J Intern Med;26(10):e59-60, 2015 Dec.
[Is] ISSN:1879-0828
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Anti-Inflamatórios não Esteroides/administração & dosagem
Síndrome da Costela Cervical
Bloqueio Neuromuscular/métodos
Modalidades de Fisioterapia
Síndrome do Desfiladeiro Torácico
[Mh] Termos MeSH secundário: Costela Cervical/diagnóstico por imagem
Síndrome da Costela Cervical/complicações
Síndrome da Costela Cervical/diagnóstico
Diagnóstico Diferencial
Feminino
Seres Humanos
Imagem por Ressonância Magnética/métodos
Meia-Idade
Síndrome do Desfiladeiro Torácico/diagnóstico
Síndrome do Desfiladeiro Torácico/etiologia
Síndrome do Desfiladeiro Torácico/fisiopatologia
Síndrome do Desfiladeiro Torácico/terapia
Tomografia Computadorizada por Raios X/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents, Non-Steroidal)
[Em] Mês de entrada:1609
[Cu] Atualização por classe:161126
[Lr] Data última revisão:
161126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150803
[St] Status:MEDLINE


  3 / 235 MEDLINE  
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[PMID]:25367418
[Au] Autor:Khatib N; Boulet J
[Ad] Endereço:Department of Undergraduate Medical Education, McGill University, Montréal, Que. nour.khatib@mail.mcgill.ca.
[Ti] Título:Thoracic outlet syndrome: a congenital case manifesting in middle age.
[So] Source:CMAJ;187(3):206, 2015 Feb 17.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Síndrome da Costela Cervical/congênito
[Mh] Termos MeSH secundário: Aneurisma/cirurgia
Síndrome da Costela Cervical/diagnóstico
Síndrome da Costela Cervical/cirurgia
Constrição Patológica
Seres Humanos
Masculino
Meia-Idade
Veia Safena/transplante
Artéria Subclávia/patologia
Artéria Subclávia/cirurgia
Procedimentos Cirúrgicos Vasculares
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1507
[Cu] Atualização por classe:151029
[Lr] Data última revisão:
151029
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:141105
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.140552


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[PMID]:25489375
[Au] Autor:Elouakili I; Ouchrif Y
[Ad] Endereço:Service de Chirurgie Orthopédique, CHU de Rabat, Maroc.
[Ti] Título:[Naffziger syndrome].
[Ti] Título:Syndrome de Naffziger..
[So] Source:Pan Afr Med J;18:281, 2014.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Mh] Termos MeSH primário: Neuropatias do Plexo Braquial/etiologia
Síndrome da Costela Cervical/complicações
Costelas/anormalidades
[Mh] Termos MeSH secundário: Adulto
Síndrome da Costela Cervical/diagnóstico por imagem
Seres Humanos
Masculino
Radiografia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1507
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141210
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2014.18.281.5198


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[PMID]:25237978
[Au] Autor:Kinge NG; Paliwal VK; Neyaz Z; Sharma R
[Ti] Título:Retrograde thromboembolic vertebrobasilar artery infarct due to right cervical rib.
[So] Source:Neurol India;62(4):479-80, 2014 Jul-Aug.
[Is] ISSN:0028-3886
[Cp] País de publicação:India
[La] Idioma:eng
[Mh] Termos MeSH primário: Síndrome da Costela Cervical/complicações
Infarto/etiologia
Tromboembolia/etiologia
Insuficiência Vertebrobasilar/etiologia
[Mh] Termos MeSH secundário: Costela Cervical
Seres Humanos
Masculino
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1411
[Cu] Atualização por classe:140920
[Lr] Data última revisão:
140920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140920
[St] Status:MEDLINE
[do] DOI:10.4103/0028-3886.141310


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[PMID]:24630141
[Au] Autor:Tzou CH; Paternostro-Sluga T; Frey M; Aszmann OC
[Ad] Endereço:Div. of Plastic and Reconstructive Surgery, Dept. of Surgery, Medical University of Vienna, Austria.
[Ti] Título:Birth brachial plexus palsy caused by cervical rib.
[So] Source:J Plast Reconstr Aesthet Surg;67(7):1004-5, 2014 Jul.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Neuropatias do Plexo Braquial/etiologia
Síndrome da Costela Cervical/complicações
Neuroma/complicações
Neoplasias do Sistema Nervoso Periférico/complicações
[Mh] Termos MeSH secundário: Síndrome da Costela Cervical/diagnóstico
Síndrome da Costela Cervical/cirurgia
Feminino
Seres Humanos
Lactente
Recém-Nascido
Neuroma/cirurgia
Neoplasias do Sistema Nervoso Periférico/cirurgia
Raízes Nervosas Espinhais
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Em] Mês de entrada:1407
[Cu] Atualização por classe:140609
[Lr] Data última revisão:
140609
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:140318
[St] Status:MEDLINE


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[PMID]:24316293
[Au] Autor:Weber AE; Criado E
[Ad] Endereço:Department of Orthopaedic Surgery, University of Michigan School of Medicine, Ann Arbor, MI.
[Ti] Título:Relevance of bone anomalies in patients with thoracic outlet syndrome.
[So] Source:Ann Vasc Surg;28(4):924-32, 2014 May.
[Is] ISSN:1615-5947
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Skeletal anomalies are recognized as potential causes of thoracic outlet syndrome (TOS); however, there is a paucity of information regarding the specific bone anomalies associated with TOS and their relative incidence among the different clinical types of TOS. This study describes the prevalence of bone anomalies in a population with TOS. METHODS: A retrospective chart review of the clinical records and imaging studies of all patients who were surgically treated at our institution for TOS between 1991-2011 was conducted. A descriptive analysis of the cohort of patients with associated bone anomalies was performed and compared with the cohort of patients without bone anomalies. RESULTS: During the study period, 400 patients underwent operative procedures for TOS. Of these, 115 (29%) harbored a bone anomaly and the remaining 285 did not. The bone anomalies included 80 (69%) cervical ribs, 25 (22%) clavicular anomalies, and 10 (9%) isolated first rib aberrations. Ninety (78%) of the bone anomalies were congenital, while 25 (22%) were posttraumatic. The bone anomaly cohort was predominantly female (76%), with an average age of 36 years. The distribution of neurogenic, arterial, and venous types of TOS in the cohort with bone anomalies was 63%, 33%, and 4%, respectively, while it was 51% neurogenic, 11% arterial, and 38% venous in the cohort without bone anomalies. These distributions were significantly different (chi-squared: 56.75; P < 0.0001). The likelihood of neurogenic compression was roughly equivalent between the 2 cohorts (odds ratio [OR]: 1.6; P = 0.03), while the likelihood of arterial compression was much higher in the presence of a bone anomaly (OR: 4.0; P < 0.001) and the likelihood of venous compression was much lower in the presence of bone anomaly (OR: 0.07; P < 0.001). Conversely, 33% of all neurogenic TOS cases, 54% of all arterial TOS cases, and 4% of all venous TOS cases were associated with a bone anomaly. CONCLUSIONS: In our experience, the incidence of bone anomalies among patients treated for TOS was 29%, which is higher than previously reported. Cervical ribs were present in 20% of our patients with TOS, an estimated 40 times higher prevalence than that in the general population. However, acquired clavicular deformities and isolated abnormal first ribs were found in 9% of our patients, accounting for almost one-third of all bone anomalies present in this TOS population. The incidence of bone anomalies is rather different among the subtypes of TOS. The strongest association with the presence of a bone anomaly occurs in patients with arterial TOS, although 46% of all our arterial TOS cases did not have a bone anomaly. The presence of bone anomalies does not seem to influence the occurrence of neurogenic TOS, while venous TOS likely has no association with congenital bone anomalies, but occasionally mid and medial clavicular fracture calluses may cause venous TOS.
[Mh] Termos MeSH primário: Osso e Ossos/anormalidades
Fraturas Ósseas/epidemiologia
Anormalidades Musculoesqueléticas/epidemiologia
Síndrome do Desfiladeiro Torácico/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Osso e Ossos/diagnóstico por imagem
Costela Cervical/anormalidades
Síndrome da Costela Cervical/epidemiologia
Distribuição de Qui-Quadrado
Criança
Clavícula/anormalidades
Clavícula/lesões
Descompressão Cirúrgica
Feminino
Fraturas Ósseas/diagnóstico por imagem
Seres Humanos
Incidência
Masculino
Michigan/epidemiologia
Meia-Idade
Anormalidades Musculoesqueléticas/diagnóstico por imagem
Razão de Chances
Prevalência
Radiografia
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Síndrome do Desfiladeiro Torácico/diagnóstico
Síndrome do Desfiladeiro Torácico/cirurgia
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1510
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:131210
[St] Status:MEDLINE


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[PMID]:23860698
[Au] Autor:Atasoy E
[Ad] Endereço:Kleinert Kutz Hand Care Center, Louisville, Kentucky 40202, USA. eatasoy@kleinertkutz.com
[Ti] Título:A hand surgeon's advanced experience with thoracic outlet compression syndrome.
[So] Source:Handchir Mikrochir Plast Chir;45(3):131-50, 2013 Jun.
[Is] ISSN:1439-3980
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Although hand surgeons may often see patients with arm and hand pain, numbness and tingling in their practice, the possibility of the presence of thoracic outlet compression syndrome (TOCS) is not often considered. In our practice almost half of newly referred patients have the complaint of upper extremity pain, numbness and tingling. In approximately 50% of these patients detailed history and physical examination are suggestive of TOCS. For this reason it is quite important to recognize the possibility of the existence of this condition. Very often in the past, and occasionally today, this condition has been considered a controversial subject by numerous physicians because of the absence of objective findings in many patients. For several years it has been very well known that the objective findings are present in about 10% of patients and the remaining 90% of patients have subjective complaints. For this reason it has been one of the most commonly underrated, overlooked, and misdiagnosed conditions. During the last 22 years our experience with combined surgical approach for this condition (transaxillary first rib resection with immediate transcervical anterior and middle scalenectomy) has been quite satisfactory. During these years over 850 of these procedures were performed. Between 1989 and 2002 (13 years) 532 patients from a wide geographic area had this combined approach procedure. We were able to locate 358 of these patients for follow-up and of those only 102 responded to our questionnaire. Of the 102 who responded, 95 reported improvement of their symptoms. From 2003 to the middle of 2012, 350 patients from a wide region had this combined procedure. We sent a questionnaire to these patients and had only 57 to respond. Of those who responded, there were 19 bilateral interventions performed a few months apart, with a total of 76 procedures performed. Results based on these 76 procedures revealed 95% improvement of their symptoms. This combined approach for TOCS is the most complete intervention with high rate of improvement and low rate of recurrences.
[Mh] Termos MeSH primário: Descompressão Cirúrgica/métodos
Mãos/inervação
Mãos/cirurgia
Especialidades Cirúrgicas
Síndrome do Desfiladeiro Torácico/cirurgia
[Mh] Termos MeSH secundário: Síndrome da Costela Cervical/diagnóstico
Síndrome da Costela Cervical/cirurgia
Descompressão Cirúrgica/instrumentação
Diagnóstico Diferencial
Seres Humanos
Hipestesia/etiologia
Hipestesia/cirurgia
Microcirurgia/métodos
Neuralgia/etiologia
Neuralgia/cirurgia
Parestesia/etiologia
Parestesia/cirurgia
Satisfação do Paciente
Modalidades de Fisioterapia
Cuidados Pós-Operatórios
Recidiva
Instrumentos Cirúrgicos
Inquéritos e Questionários
Síndrome do Desfiladeiro Torácico/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1404
[Cu] Atualização por classe:151119
[Lr] Data última revisão:
151119
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130718
[St] Status:MEDLINE
[do] DOI:10.1055/s-0033-1348312


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[PMID]:23446121
[Au] Autor:Chang KZ; Likes K; Davis K; Demos J; Freischlag JA
[Ad] Endereço:Division of Vascular and Endovascular Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
[Ti] Título:The significance of cervical ribs in thoracic outlet syndrome.
[So] Source:J Vasc Surg;57(3):771-5, 2013 Mar.
[Is] ISSN:1097-6809
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The purpose of this study was to review our operative experience in patients with thoracic outlet syndrome (TOS) resulting from cervical ribs causing clinical symptoms. METHODS: This study is a retrospective review of a prospectively acquired database of patients with TOS treated with first rib resection and scalenectomy with or without cervical rib resection at the Johns Hopkins Medical Institutions. RESULTS: Between October 2003 and June 2011, a total of 23 cervical rib resections were performed on 20 patients, three of whom had bilateral cervical ribs resected during separate operations. Seven patients presented with subclavian artery thrombosis. Three of seven patients had subclavian artery aneurysms and underwent cervical rib resection through a supraclavicular approach to facilitate subclavian artery bypass. Five patients presented with an ischemic upper extremity without thrombosis and underwent transaxillary first rib and cervical rib resection. Three patients presented with subclavian vein thrombosis; two of the three patients underwent balloon dilation 2 weeks postoperatively for stenosis. Additionally, five patients presented with neurogenic TOS evidenced by pain, numbness, and weakness without vascular compromise in the affected arm. Cervical ribs with bony fusion to the first rib were found in 17 of 23 cases (74%). CONCLUSIONS: Cervical ribs causing clinical symptoms are large and frequently fused to the first rib, and can result in aneurysm formation or thrombosis. In our experience, both the cervical rib and the first rib must be removed to relieve arterial compression and can usually be done through a transaxillary approach. Only patients with aneurysms needing arterial reconstruction require resection of the artery from a supraclavicular approach.
[Mh] Termos MeSH primário: Síndrome da Costela Cervical/cirurgia
Costela Cervical/cirurgia
Osteotomia
Síndrome do Desfiladeiro Torácico/cirurgia
Extremidade Superior/irrigação sanguínea
[Mh] Termos MeSH secundário: Adolescente
Adulto
Aneurisma/etiologia
Aneurisma/cirurgia
Baltimore
Costela Cervical/anormalidades
Costela Cervical/diagnóstico por imagem
Síndrome da Costela Cervical/diagnóstico
Síndrome da Costela Cervical/etiologia
Feminino
Seres Humanos
Isquemia/etiologia
Isquemia/cirurgia
Masculino
Meia-Idade
Radiografia
Estudos Retrospectivos
Síndrome do Roubo Subclávio/etiologia
Síndrome do Roubo Subclávio/cirurgia
Síndrome do Desfiladeiro Torácico/diagnóstico
Síndrome do Desfiladeiro Torácico/etiologia
Trombose/etiologia
Trombose/cirurgia
Resultado do Tratamento
Ultrassonografia Doppler Dupla
Procedimentos Cirúrgicos Vasculares
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1304
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:130301
[St] Status:MEDLINE


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[PMID]:23266168
[Au] Autor:Lebhar J; Marleix S; Fraisse B; Chapuis M; Bruneau B; Violas P
[Ad] Endereço:Service de chirurgie pédiatrique, hôpital Sud, boulevard de Bulgarie, Rennes, France. phillippe.violas@chu-rennes.fr
[Ti] Título:[Thoracic outlet syndrome in a child: a rare pediatric diagnosis].
[Ti] Título:Syndrome du défilé thoraco-brachial par côte surnuméraire : un diagnostic rare en pédiatrie..
[So] Source:Arch Pediatr;20(1):30-2, 2013 Jan.
[Is] ISSN:1769-664X
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Thoracic outlet syndrome (TOS) is a rare pediatric syndrome and few cases have been reported in the literature. The authors report the case of a 10-year-old boy with generalized arm pain and neck stiffness. The angiocomputed tomography revealed the presence of a TOS caused by an additional cervical rib and stenosis of the sub-clavian artery. The resection of this rib relieved the patient of his pain during a full year following surgery. This case reminds us that children can also be affected by TOS. When a cervical rib causes TOS, a resection is often necessary.
[Mh] Termos MeSH primário: Síndrome da Costela Cervical/diagnóstico por imagem
Costela Cervical/anormalidades
[Mh] Termos MeSH secundário: Angiografia
Braço
Síndrome da Costela Cervical/etiologia
Síndrome da Costela Cervical/cirurgia
Criança
Seres Humanos
Masculino
Pescoço
Dor/etiologia
Parestesia/etiologia
Doenças Raras
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1307
[Cu] Atualização por classe:161125
[Lr] Data última revisão:
161125
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121226
[St] Status:MEDLINE



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