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Neurology (Expert Forum)
Thoracic Outlet syndrome surgery
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Thoracic Outlet syndrome surgery
by lorak, Jun 14, 2006 12:00AM
I had surgery 6 months ago to remove a cervical rib and first rib due to TOC, the only test done was an upper extremity ultrasound and I was adviced to have one cervical rib removed, then the other.
Since the surgery my arm, shoulder, thumb and upper chest area, neck and chin have numbness, I have electric shock feelings, my muscles are very weak and this is so much worse than before.
The main symptom before was numbness and tingling when my arms were raised and some pain. The Dr. adviced if I didn't have the surgery my muscles would eventually atrophy and I risk a blood clot.
I was not given physical therapy at all.
I went to a follow up with another surgeon in the same office, as my surgeon in not practicing medicine at this time, and they did another upper extremity test and said results were fine, I should go to Physical therapy, and there was no need for any additional testings and my symptoms couldn't be neurological because the surgeon did not cut a nerve.
I recently found your website and hope you have some advice for me.
Since the surgery my arm, shoulder, thumb and upper chest area, neck and chin have numbness, I have electric shock feelings, my muscles are very weak and this is so much worse than before.
The main symptom before was numbness and tingling when my arms were raised and some pain. The Dr. adviced if I didn't have the surgery my muscles would eventually atrophy and I risk a blood clot.
I was not given physical therapy at all.
I went to a follow up with another surgeon in the same office, as my surgeon in not practicing medicine at this time, and they did another upper extremity test and said results were fine, I should go to Physical therapy, and there was no need for any additional testings and my symptoms couldn't be neurological because the surgeon did not cut a nerve.
I recently found your website and hope you have some advice for me.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jun 18, 2006 12:00AM
I cannot give you a formal medical opinion over the internet, as this site is purely educational
Neurological TOC is actually quite rare, and is difficult to diagnose. There are alot of nerves in the area of the cervical rib, so there may have been potential nerve damage during the surgery. Alternatively, whatever process was causing the symptoms (if it was not TOC) may still be in process, causing the symptoms, for example, pinched nerves in the neck
It may be difficult to tell the differnece at this stage. An EMG study of the shoulder and arm may be able to detect what sort of nerve injury is present if any. Perhaps a second opinion outside this practise, with an EMG and nerve conductiuon study may be revealing
Good luck
Neurological TOC is actually quite rare, and is difficult to diagnose. There are alot of nerves in the area of the cervical rib, so there may have been potential nerve damage during the surgery. Alternatively, whatever process was causing the symptoms (if it was not TOC) may still be in process, causing the symptoms, for example, pinched nerves in the neck
It may be difficult to tell the differnece at this stage. An EMG study of the shoulder and arm may be able to detect what sort of nerve injury is present if any. Perhaps a second opinion outside this practise, with an EMG and nerve conductiuon study may be revealing
Good luck
I, at times, have constant pain in and around that same area - along with tingling, numbness, weakness, etc. I have trouble sleeping and relaxing in general. In addition, there are times when I have terrible stiff neck (though it really isn’t my next – it just feels like it, it seems) that lasts for weeks. I’ve gone to many doctors and have tried the following with no ‘long-term’ success:
1. Various types of massage
2. Physical Therapy
3. Ultrasound
4. Acupuncture
5. Rolfing
6. Exercise
7. I’m sure there are others
I’ve been told by a couple of doctors (Northwestern’s Rehabilitation Institute of Chicago, and Cardiovascular division) that I have Thoracic Outlet Syndrome. My doctor has told me that surgery is the last possible option – and considering what I’ve already done above, I don’t know what else I can do to improve my situation. I’m sick and tired of waking up sore and feeling like I’m 60 years old.
I am leaning towards having the surgery in a couple of months – but to be honest, based on my research, I’m very hesitant. Can anyone offer any advice on some metrics that are out there in terms of the following?
1. Success Rates
2. Failure Rates
3. Who are the best doctors?
4. Patient Comments / Recommendations
5. Etc.
Thank you very much for your time – I find this website to be very informative and educating.
Best Regards
I, at times, have constant pain in and around that same area - along with tingling, numbness, weakness, etc. I have trouble sleeping and relaxing in general. In addition, there are times when I have terrible stiff neck (though it really isn’t my next – it just feels like it, it seems) that lasts for weeks. I’ve gone to many doctors and have tried the following with no ‘long-term’ success:
1. Various types of massage
2. Physical Therapy
3. Ultrasound
4. Acupuncture
5. Rolfing
6. Exercise
7. I’m sure there are others
I’ve been told by a couple of doctors (Northwestern’s Rehabilitation Institute of Chicago, and Cardiovascular division) that I have Thoracic Outlet Syndrome. My doctor has told me that surgery is the last possible option – and considering what I’ve already done above, I don’t know what else I can do to improve my situation. I’m sick and tired of waking up sore and feeling like I’m 60 years old.
I am leaning towards having the surgery in a couple of months – but to be honest, based on my research, I’m very hesitant. Can anyone offer any advice on some metrics that are out there in terms of the following?
1. Success Rates
2. Failure Rates
3. Who are the best doctors?
4. Patient Comments / Recommendations
5. Etc.
Thank you very much for your time – I find this website to be very informative and educating.
Best Regards