Thoracic outlet syndrome: diagnostic evaluation by analgesic cervical disk puncture.

Thoracic outlet syndrome was treated by resection of the first rib in 19 patients, nine of whom were preoperatively evaluated by means of analgesic cervical disk puncture to discover whether the symptoms stemmed from diskogenic causes. The overall results after operation were excellent in 68% (13/19). In patients who had a positive test outcome of the analgesic cervical disk puncture, the symptoms remained unchanged after the operation, while in those who had a negative test result, late postoperative results were excellent in 100% (7/7). This was significantly better than the late results obtained in a group of patients evaluated and operated upon without the test. Analgesic cervical disk puncture may be a valuable differential diagnostic test in cases of suspected thoracic outlet syndrome.