Batt M, Griffet J, Scotti L, Le Bas P
J Chir (Paris). 1983 Dec;120(12):687-91.
A total of 112 operations were performed in 87 patients with a cervicobrachial syndrome, 25 with bilateral lesions, over a period of 8 years. Surgery was reserved for severe or complicated cases. Presenting signs were complex and intricated in 53 p. cent of cases, with neurological lesions predominating. Absence of radial pulse after 90 degrees abduction of the arm, present in 87 p. cent of patients, is not a specific diagnostic test as positive results are obtained in over one-third of a normal population. Electromyography confirmed clinical lesions of the brachial plexus in only one out of 8 cases. A more precise and more sensitive procedure for electromyographic exploration of the plexus was therefore established. Dynamic arteriography of the upper limbs was not conducted routinely (70 p. cent of cases), but was reserved for arterial, neuro-arterial, and arterial and venous forms. The axillary approach was used exclusively (94 times), between 1974 and 1980. However, the frequency of postoperative complications (10 p. cent), and the high level of poor or incomplete results (19.5 p. cent) led to the reestablishment of the supraclavicular route of approach. The latter is used preferentially in neurological forms (57 p. cent of cases in this series) in cases requiring correction of an arterial lesion (aneurysm, ulcerated plaque), or when a cervical rib or apophysomegalia of the 7th cervical vertebra is associated.
在8年的时间里，对87例患有颈臂综合征的患者共进行了112次手术，其中25例为双侧病变。手术仅用于严重或复杂病例。53%的病例临床表现复杂，以神经病变为主。87%的患者在手臂外展90度后桡动脉搏动消失，但这并非特异性诊断试验，因为在超过三分之一的正常人群中也可得到阳性结果。8例患者中仅1例经肌电图证实存在臂丛神经临床病变。因此，建立了一种更精确、更敏感的臂丛神经肌电图检查方法。上肢动态动脉造影并非常规进行（70%的病例），仅用于动脉型、神经动脉型以及动静脉型。1974年至1980年间仅采用腋路（94次）。然而，术后并发症发生率（10%）以及较差或不完全恢复的比例较高（19.5%），促使重新采用锁骨上路。在本系列中，锁骨上路优先用于神经型病例（占57%），以及需要纠正动脉病变（动脉瘤、溃疡性斑块）的情况，或伴有颈肋或第7颈椎椎体增大的病例。
