Supraclavicular scalenectomy for thoracic outlet syndrome-functional outcomes assessed using the DASH scoring system

Introduction: To evaluate supraclavicular scalenectomy ± cervical rib excision for thoracic outlet syndrome (TOS), employing Disability of Arm, Shoulder, and Hand (DASH) scoring for functional assessment post-decompression. Methods: A QuickDASH score was calculated for each patient using the algorithm: ([sum of responses/n] - 1) × 25, where n = number of completed responses. Nonparametric analysis was employed, with significance defined as P ≤.05. Results: Twenty-one patients were treated for TOS by the same surgeon; with 5 bilateral procedures (total = 26 procedures). Median DASH scores pre- and postoperatively were 68.5 and 36.0, respectively (P =.002). Just one reported worsening of symptoms postoperatively. Antecedent trauma and smoking were inversely associated with DASH score postoperatively (P =.005 and P =.005). Postoperative scores were less for patients with vascular symptoms (P =.011); scores did not change significantly for those with neurologic (P =.066) or mixed symptoms (P =.345). Conclusions: This study reconfirmed the value of supraclavicular approach for TOS, with the vast majority reporting subjective improvement.