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Peer-reviewedCC BYFrontiers in neurology

Neurogenic thoracic outlet syndrome: a review of diagnostic and therapeutic strategies.

  • Guang-Yao Li1
  • Ming-Qiang Xue1
  • Jing-Wei Wang1
  • Ke Sha1,2,3
  1. 1Department of Orthopedic Trauma and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
  2. 2Research Centre for Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China.
  3. 3Guangxi Key Laboratory of Regenerative Medicine, Guangxi Medical University, Nanning, Guangxi, China.
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Abstract

The diagnosis and treatment of neurogenic thoracic outlet syndrome (nTOS) remain challenging. Although consensus-based clinical frameworks exist, they lack robust externa validation. This study conducts a review of nTOS publications in the PubMed, Embase, and Web of Science databases, with a search cutoff date of December 2025. Current evidence suggests that the incidence of nTOS may be underestimated. Diagnosis should be based on a comprehensive evaluation, including medical history, systematic physical examination, ancillary examinations, diagnostic muscle block, and exclusion of other possible diseases. Treatment should be carried out in a phased manner. For mild cases, nonsurgical treatment is preferred. For patients who experience progressive neurological dysfunction, muscle atrophy, or failure of conservative treatment, timely surgery should be considered. Surgical decompression mainly involves the supraclavicular or axillary approaches. Surgical techniques include first rib resection, rib-sparing scalenectomy, pectoralis minor release, cervical rib resection. However, the optimal treatment remains controversial due to the limited availability of high-quality evidence. Future research should focus on elucidating the pathophysiology of nTOS, improving diagnostic accuracy through technological innovation, and optimizing treatment protocols through prospective multicenter studies.

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Cite

BibTeXRIS
BibTeX
@article{li2026neurogenic,
  title = {{Neurogenic thoracic outlet syndrome: a review of diagnostic and therapeutic strategies.}},
  author = {Guang-Yao Li and Ming-Qiang Xue and Jing-Wei Wang and Ke Sha},
  journal = {Frontiers in neurology},
  year = {2026},
  month = oct,
  doi = {10.3389/fneur.2026.1932666},
  url = {https://europepmc.org/article/MED/42903390},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Neurogenic thoracic outlet syndrome: a review of diagnostic and therapeutic strategies.
AU  - Guang-Yao Li
AU  - Ming-Qiang Xue
AU  - Jing-Wei Wang
AU  - Ke Sha
PY  - 2026
DA  - 2026/10/06
JO  - Frontiers in neurology
DO  - 10.3389/fneur.2026.1932666
UR  - https://europepmc.org/article/MED/42903390
AB  - The diagnosis and treatment of neurogenic thoracic outlet syndrome (nTOS) remain challenging. Although consensus-based clinical frameworks exist, they lack robust externa validation. This study conducts a review of nTOS publications in the PubMed, Embase, and Web of Science databases, with a search cutoff date of December 2025. Current evidence suggests that the incidence of nTOS may be underestimated. Diagnosis should be based on a comprehensive evaluation, including medical history, systematic physical examination, ancillary examinations, diagnostic muscle block, and exclusion of other possible diseases. Treatment should be carried out in a phased manner. For mild cases, nonsurgical treatment is preferred. For patients who experience progressive neurological dysfunction, muscle atrophy, or failure of conservative treatment, timely surgery should be considered. Surgical decompression mainly involves the supraclavicular or axillary approaches. Surgical techniques include first rib resection, rib-sparing scalenectomy, pectoralis minor release, cervical rib resection. However, the optimal treatment remains controversial due to the limited availability of high-quality evidence. Future research should focus on elucidating the pathophysiology of nTOS, improving diagnostic accuracy through technological innovation, and optimizing treatment protocols through prospective multicenter studies.
SN  - 1664-2295
ER  -