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锁骨上颈椎肋骨切除术导致胸廓出口综合征:二维手术视频。

Supraclavicular Resection of a Cervical Rib Causing Thoracic Outlet Syndrome: 2-Dimensional Operative Video.

机构信息

Miami Project to Cure Paralysis, Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, Florida.

出版信息

Oper Neurosurg (Hagerstown). 2020 Oct 15;19(5):E520. doi: 10.1093/ons/opaa139.

Abstract

Presence of a cervical rib results from overdevelopment of the seventh cervical vertebrae.1-3 The cervical rib along with scalene muscles can cause neurogenic thoracic outlet syndrome.4,5 Rib resection is typically done via anterior approach, using either supraclavicular or transaxillary route.6,7 We present an operative video detailing supraclavicular resection of a cervical rib causing neurogenic thoracic outlet syndrome with direct decompression of the lower trunk of the brachial plexus. The patient presented with severe symptoms including hand atrophy. We were able to directly visualize the rib and resect it, along with scalene musculature. We present 3-mo follow-up data noting clinical improvement in neuropathic symptoms.

摘要

颈肋的出现是由于第七颈椎过度发育。1-3 颈肋与斜角肌一起可引起神经性胸廓出口综合征。4,5 肋骨切除术通常通过前入路进行,使用锁骨上或腋窝入路。6,7 我们展示了一个手术视频,详细描述了颈肋引起的神经性胸廓出口综合征的锁骨上切除术,直接减压臂丛下干。患者表现出严重的症状,包括手部萎缩。我们能够直接观察到肋骨并将其与斜角肌一起切除。我们呈现了 3 个月的随访数据,指出神经症状的临床改善。

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