A novel diagnostic scale for diagnosis of surgical neurogenic thoracic outlet syndrome (tos)

Background: Diagnosing thoracic outlet syndrome (TOS) can be challenging because the symptoms vary greatly amongst patients with the disorder, thus lending to other conditions including a double crush syndrome. Adjunct diagnostic studies frequently confirm the diagnosis of VTOS (venous thoracic outlet syndrome) and ATOS (arterial thoracic outlet syndrome), but not of NTOS (neurogenic thoracic outlet syndrome), so a new diagnostic scale was applied for NTOS. Aim of the study: evaluation of the new diagnostic scale for management of neurogenic thoracic outlet syndrome. Patients and methods: the new diagnostic scale was applied on a forty patients with neurogenic thoracic outlet syndrome. They were selected from Al-Azhar University hospitals between Jan 2008 and December 2017.Conservative treatment was decided for all patients for one month, then surgery for the failed cases, then evaluation after 6 months for all the 40 patients. Results: All patients scored below 5(30 patients= 75%) responded well to conservative treatment. While Patients scored 5 and 6(both are 10 patients =25%) had no response to conservative treatment. So, surgery was done.6 months follow up showed improvement of all the studied cases. So this suggested novel scale helped us to decide when to decide conservative treatment and when to do surgery. Conclusion: This suggested novel scale helped us to decide when to decide conservative treatment and when to do surgery.