Kline D G, Kott J, Barnes G, Bryant L
J Neurosurg. 1978 Dec;49(6):872-80. doi: 10.3171/jns.1978.49.6.0872.
The application of an old surgical technique, previously employed for treatment of thoracic outlet syndromes, to lesions of the brachial plexus is discussed. Positioning of the patient, the surgical procedure, and selected indications for a posterior subscapular approach with resection of the first rib are discussed. The indications for the use of this approach are: proximal plexus lesions involving roots and/or trunks believed to be repairable, complicated thoracic outlet syndromes, prior anterior exploration for vascular or nervous structure disease, and progressive plexus palsy associated with damage to the soft tissue of the anterior chest wall and supraclavicular regions secondary to irradiation. The authors' experience to date with 12 such cases is presented in chart form, while five cases are presented in some detail.
讨论了一种曾用于治疗胸廓出口综合征的古老外科技术在臂丛神经损伤中的应用。讨论了患者的体位、手术步骤以及采用切除第一肋的肩胛下后入路的选定适应症。使用该入路的适应症为：累及神经根和/或干且认为可修复的近端神经丛损伤、复杂的胸廓出口综合征、先前因血管或神经结构疾病进行的前路探查，以及与放疗继发的前胸壁和锁骨上区域软组织损伤相关的进行性神经丛麻痹。作者目前对12例此类病例的经验以图表形式呈现，同时详细介绍了5例病例。
