Thoracic Outlet Syndrome Part I: Systematic Review of the Literature and Consensus on Anatomy, Diagnosis, and Classification of Thoracic Outlet Syndrome by the European Association of Neurosurgical Societies' Section of Peripheral Nerve Surgery.
[en] [en] BACKGROUND: Although numerous articles have been published not only on the classification of thoracic outlet syndrome (TOS) but also on diagnostic standards, timing, and type of surgical intervention, there still remains some controversy because of the lack of level 1 evidence. So far, attempts to generate uniform reporting standards have not yielded conclusive results.
OBJECTIVE: To systematically review the body of evidence and reach a consensus among neurosurgeons experienced in TOS regarding anatomy, diagnosis, and classification.
METHODS: A systematic literature search on PubMed/MEDLINE was performed on February 13, 2021, yielding 2853 results. Abstracts were screened and classified. Recommendations were developed in a meeting held online on February 10, 2021, and refined according to the Delphi consensus method.
RESULTS: Six randomized controlled trials (on surgical, conservative, and injection therapies), 4 "guideline" articles (on imaging and reporting standards), 5 observational studies (on diagnostics, hierarchic designs of physiotherapy vs surgery, and quality of life outcomes), and 6 meta-analyses were identified. The European Association of Neurosurgical Societies' section of peripheral nerve surgery established 18 statements regarding anatomy, diagnosis, and classification of TOS with agreement levels of 98.4 % (±3.0).
CONCLUSION: Because of the lack of level 1 evidence, consensus statements on anatomy, diagnosis, and classification of TOS from experts of the section of peripheral nerve surgery of the European Association of Neurosurgical Societies were developed with the Delphi method. Further work on reporting standards, prospective data collections, therapy, and long-term outcome is necessary.
Disciplines :
Neurology
Author, co-author :
Dengler, Nora Franziska ; Department of Neurosurgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
Ferraresi, Stefano ; Department of Neurosurgery, Ospedale Santa Maria della Misericordia, Rovigo, Italy
Rochkind, Shimon ; Division of Peripheral Nerve Reconstruction, Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv-Yafo, Israel
Denisova, Natalia ; Department of Functional Neurosurgery, Federal Neurosurgical Center, Novosibirsk, Russia
Garozzo, Debora; Department of Neurosurgery, Mediclinic Parkview Hospital, Dubai, United Arab Emirates
Heinen, Christian ; Peripheral Nerve Unit Nord, Christliches Krankenhaus Quakenbrück GmbH, Quakenbrück, Germany
Alimehmeti, Ridvan ; Department of Neurosurgery at University Hospital Center "Mother Theresa", Tirana, Albania
Capone, Crescenzo; Department of Peripheral Nerve Surgery, Ospedale Civile di Faenza, Local Health Authority of Romagna, Faenza, Italy
Barone, Damiano Giuseppe; Department of Neurosurgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK
Zdunczyk, Anna ; Department of Neurosurgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
Pedro, Maria Teresa ; Peripheral Nerve Unit, Department of Neurosurgery, BKH Günzburg at Ulm University, Günzburg, Germany
Antoniadis, Gregor ; Peripheral Nerve Unit, Department of Neurosurgery, BKH Günzburg at Ulm University, Günzburg, Germany
Kaiser, Radek ; Department of Neurosurgery and Neurooncology, First Faculty of Medicine, Charles University and Military University Hospital Prague, Praha, Czech Republic
Dubuisson, Annie ; Centre Hospitalier Universitaire de Liège - CHU > > Service de neurochirurgie
Kretschmer, Thomas ; Department of Neurosurgery & Neurorestoration, Klinikum Klagenfurt, Klagenfurt am Wörthersee, Austria
Rasulic, Lukas; Faculty of Medicine, University of Belgrade, Clinic for Neurosurgery, University Clinical Center of Serbia, Belgrade, Serbia
Thoracic Outlet Syndrome Part I: Systematic Review of the Literature and Consensus on Anatomy, Diagnosis, and Classification of Thoracic Outlet Syndrome by the European Association of Neurosurgical Societies' Section of Peripheral Nerve Surgery.
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