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Controversies in NTOS: To Remove the First Rib or Not?

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Thoracic Outlet Syndrome

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Abstract

The first rib may not always require excision in NTOS. It has been shown that the pathology is in the scalene muscles (fibrosis), not in the rib. Scalenectomy alone has as good a long-term improvement rate as first rib resection, and rib resection results in more complications and morbidity. However, if when performing scalenectomy, the lower trunk of the brachial plexus is found to lie touching the first rib, it should be excised.

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References

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Authors and Affiliations

  1. Department of Surgery, HealthONE Presbyterian-St. Lukes Hospital, 4545 E. 9th Ave #240, Denver, CO, 80220, USA

    Richard J. Sanders MD

Authors
  1. Richard J. Sanders MD
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Correspondence to Richard J. Sanders MD .

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Editors and Affiliations

  1. , Division of Vascular Surgery, University of South Florida, Tampa General Circle, STC 7016 2, Tampa, 33606, Florida, USA

    Karl A. Illig

  2. Barnes-Jewish Hospital, Department of Surgery, Washington University, Queeny Tower Campus Box, St. Louis, 63110, Missouri, USA

    Robert W. Thompson

  3. , Department of Surgery, John Hopkins Medical Institutions, Rutland Avenue - Ross 759 729, Baltimore, 21205, Maryland, USA

    Julie Ann Freischlag

  4. , Department of Thoracic Surgery, Blake 15, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, Massachusetts, USA

    Dean M. Donahue

  5. Neurological Associates of West LA, Wilshire Blvd, Suite 790 2811, Santa Monica, 90403, California, USA

    Sheldon E. Jordan

  6. , Graduate Program in Physical Therapy, UCSF/SFSU, Balmoral Street 2429, Union City, 94587, California, USA

    Peter I. Edgelow

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© 2013 Springer-Verlag London

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Sanders, R.J. (2013). Controversies in NTOS: To Remove the First Rib or Not?. In: Illig, K., Thompson, R., Freischlag, J., Donahue, D., Jordan, S., Edgelow, P. (eds) Thoracic Outlet Syndrome. Springer, London. https://doi.org/10.1007/978-1-4471-4366-6_45

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  • DOI: https://doi.org/10.1007/978-1-4471-4366-6_45

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4365-9

  • Online ISBN: 978-1-4471-4366-6

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