Abstract：
Neurogenic thoracic outlet syndrome results from compression of the brachial plexus. The symptoms are mainly pain, upper-limb weakness and paresthesia. Management always starts with a rehabilitation program, but failure of rehabilitation may necessitate surgery. In practice, we observed that several patients developed secondary distal nerve entrapment in the months following surgery, with no preoperative compression. We aimed to assess the occurrence of distal nerve entrapment after surgery for neurogenic thoracic outlet syndrome in a retrospective cohort study. Seventy-four patients were included; 82% females; mean age, 39.4 ± 9.4 years. There were 36.5% with high intensity and 63.5% with low to moderate intensity work. Eighteen (24.3%) developed secondary upper-limb entrapment at 10.6 ± 5.8 months after surgery. Sixteen had a single entrapment and 2 had two different entrapments. In 10 cases (50%) the ulnar nerve was involved at the elbow, in 7 (35.0%) the radial nerve at the radial tunnel, and in 3 (15.0%) the median nerve. No differences were found between patients with and without secondary nerve entrapment in gender (p = 0.51), mean age (p = 0.44), symptom duration (p = 0.92) or work intensity (p = 0.26). Further studies are needed to confirm these results and to shed light on the underlying mechanisms.
摘要：
神经源性胸廓出口综合征是由臂丛神经压迫引起的。症状主要是疼痛，上肢无力和感觉异常。管理总是从康复计划开始，但是康复失败可能需要手术。在实践中,我们观察到一些患者在术后数月出现继发性远端神经卡压，没有术前压迫.我们的目的是在一项回顾性队列研究中评估神经源性胸廓出口综合征手术后远端神经卡压的发生。包括74例患者；82％的女性；平均年龄，39.4±9.4年。高强度工作占36.5％，低强度工作占63.5％。手术后10.6±5.8个月，有18例（24.3％）发生了继发性上肢卡压。16个有一个单一的截留，2个有两个不同的截留。10例(50%)尺神经累及肘部,在radial骨隧道的radial神经中的7（35.0％），3（15.0%）正中神经。有无继发性神经卡压的患者在性别上无差异(p=0.51),平均年龄(p=0.44)，症状持续时间（p=0.92）或工作强度（p=0.26）。需要进一步的研究来证实这些结果并阐明潜在的机制。
