Talutis Stephanie D, Ulloa Jesus G, Hame Sharon L, Gelabert Hugh A
Division of Vascular Surgery, Cardiovascular Center, Tufts Medical Center, Boston, MA.
Division of Vascular & Endovascular Surgery, David Geffen UCLA School of Medicine, Ronald Reagan Medical Center, University of California Los Angeles, Los Angeles, CA.
J Vasc Surg. 2025 Jul;82(1):155-162. doi: 10.1016/j.jvs.2025.01.236. Epub 2025 Mar 23.
Thoracic outlet syndrome (TOS; neurovascular compression at the thoracic outlet) is a disabling condition affecting the upper extremities. Athletes are at risk of developing TOS. Prior reports of TOS in athletes have been largely restricted to single-center experiences. No data at the level of a National Athletic Conference have been reported previously. Our objective was to describe the epidemiology of TOS in a National Collegiate Athletic Association division I conference.
Athletes with TOS were identified in the prospectively maintained Pacific 12 Health Analytics Program Database from 2016 to 2022. Data included demographics, sports, treatments, and outcome. TOS subcategories of neurogenic TOS (NTOS) and venous TOS (VTOS) were identified.
In the 7-year period studied, 15,609 athletes (6874 men and 8735 women) playing 21 sports were registered. The average age was 19.3 years (men, 18.9; women, 19.5). TOS was identified in 76 athletes (0.48%): 7 VTOS (9.2%) and 69 NTOS (90.8%). These athletes included 30 (39.5%) men and 46 (60.5%) women. TOS was found in 2.6% of tennis players, 1.3% of softball players, and 1.3% of rowers. Most TOS patients (96.0%) were managed without surgery and 84.9% experienced resolution of symptoms with physical therapy, testing, and medication. Of the 14.5% of athletes who required surgery, 72.7% experienced resolution of their symptoms postoperatively. Overall symptom resolution was noted in 81.6% (79.7% NTOS and 100% VTOS; P = .19) Unrestricted return to competition was noted in 80.6% of patients managed without surgical decompression (83.6% NTOS vs 100% VTOS). After surgery, 89.9% returned to unrestricted competition (85.7% NTOS vs 100% VTOS). Overall, successful return to unrestricted competition was noted in 95.4% (100% VTOS, 95% NTOS; P = .019). Four athletes (5.3%) graduated, not returning to competition. Return to competition data were unavailable for seven athletes (9.2%).
This report of TOS in athletes is the first based on data from a National Collegiate athletic conference. Injuries leading to TOS are rare in collegiate athletics. The risk of TOS is not distributed equally in all sports; most likely to be affected include tennis, softball, and rowing. The majority of athletes with TOS were successfully managed nonoperatively and surgical intervention was uncommon. With timely diagnosis and appropriate care, >95% of athletes with TOS return to competition.
胸廓出口综合征（TOS；胸廓出口处神经血管受压）是一种影响上肢的致残性疾病。运动员有患TOS的风险。先前关于运动员TOS的报道主要局限于单中心经验。此前尚未有全国体育联盟层面的数据报道。我们的目的是描述美国大学体育协会第一分区会议中TOS的流行病学情况。
在2016年至2022年前瞻性维护的太平洋12校健康分析项目数据库中识别出患有TOS的运动员。数据包括人口统计学信息、运动项目、治疗方法和结果。确定了神经源性TOS（NTOS）和静脉性TOS（VTOS）的TOS亚类。
在研究的7年期间，登记了参加21项运动的15609名运动员（6874名男性和8735名女性）。平均年龄为19.3岁（男性18.9岁；女性19.5岁）。76名运动员（0.48%）被诊断为TOS：7例VTOS（9.2%）和69例NTOS（90.8%）。这些运动员包括30名（39.5%）男性和46名（60.5%）女性。在2.6%的网球运动员、1.3%的垒球运动员和1.3%的赛艇运动员中发现了TOS。大多数TOS患者（96.0%）未经手术治疗，84.9%的患者通过物理治疗、检查和药物治疗症状得到缓解。在需要手术的14.5%的运动员中，72.7%的患者术后症状得到缓解。总体症状缓解率为81.6%（NTOS为79.7%，VTOS为100%；P = 0.19）。在未经手术减压治疗的患者中，80.6%的患者恢复了无限制的比赛（NTOS为83.6%，VTOS为100%）。手术后，89.9%的患者恢复了无限制的比赛（NTOS为85.7%，VTOS为100%）。总体而言，95.4%的患者成功恢复了无限制的比赛（VTOS为100%，NTOS为95%；P = 0.019）。4名运动员（5.3%）毕业，未恢复比赛。7名运动员（9.2%）没有恢复比赛的数据。
这份关于运动员TOS的报告是第一份基于全国大学体育会议数据的报告。在大学体育中，导致TOS的损伤很少见。TOS的风险在所有运动项目中分布不均；最有可能受影响的包括网球、垒球和赛艇。大多数患有TOS的运动员通过非手术治疗成功康复，手术干预并不常见。通过及时诊断和适当护理，超过95%的患有TOS的运动员恢复了比赛。
