[논문]The Efficacy of Scalene Injection in Thoracic Outlet Syndrome

Lee, Gun-Woo; Kwon, Young-Ho; Jeong, Ju-Ho; Kim, Jung-Won

doi:10.3340/jkns.2011.50.1.36

The Efficacy of Scalene Injection in Thoracic Outlet Syndrome 원문보기

Journal of Korean Neurosurgical Society = 대한신경외과학회지, v.50 no.1, 2011년, pp.36 - 39

Lee, Gun-Woo (Department of Orthopedic Surgery, Kosin University Gospel Hospital) , Kwon, Young-Ho (Department of Orthopedic Surgery, Kosin University Gospel Hospital) , Jeong, Ju-Ho (Department of Neurosurgery, Kosin University Gospel Hospital) , Kim, Jung-Won (Department of Occupational and Environmental Medicine, Kosin University Gospel Hospital)

Abstract ▼ AI-Helper

Objective : To evaluate the efficacy of scalene injection in patients with thoracic outlet syndrome. Methods : We selected 142 patients diagnosed with thoracic outlet syndrome between January 2005 and October 2009. We performed a series of scalene injection with conservative treatment in all cases. Patients rated their pain degrees using a visual analogue scale. We also evaluated the time to return to everyday life and work, and patients' functional capacity. Results : There were no complications or instances of inadvertent somatic or sympathetic ganglionic blockade after scalene injection. Overall, 111 patients (76.5%) experienced improved symptoms after the first set of scalene injection and 128 patients (88.2%) improved after scalene injection followed by conservative treatment. Of the 68 patients who returned to work during the study period, 54 returned within 1 week, and 62 within 2 weeks. Of those who returned to work, 61 reported nearly full functional capacity. We found that scalene injection was more effective in cases of thoracic outlet syndrome related to trauma than in those related to work-related repetitive stress. Conclusion : In patients with thoracic outlet syndrome, scalene injection effectively reduces pain. We recommend scalene injection as an adjunct to conservative treatment.

주제어

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문제 정의

The scientific literature contains very few reports regarding the efficacy of further TOS treatments after failed scalene injection. Sheldon et al.

제안 방법

Temporary pain relief after the scalene injection support the diagnosis of TOS, but the relief is short-lived^3,10). In this study, we investigated scalene injection as an initial treatment method for TOS.
Patients rated their pain using a visual analogue scale (VAS; 0=no pain, 10=worst pain imaginable) at the time of diagnosis, after the scalene injection, and during the follow-up period. We recorded VAS scores and clinical results immediately after the procedure and after 1 month, 6 months, and 1 year by telephone interview¹⁰⁾.

대상 데이터

Patients were comprised of 74 men and 68 women with a mean age of 47 years (range 18-80) and a mean follow-up period of 38 months (range 12-64). Their TOS etiologies included 71 cases of trauma-related injury and 71 cases of work-related repetitive stress.
The trauma-related injuries included 38 cases of whiplash caused by traffic accidents, 18 cases of upper limb abduction-compression caused by breaking one’s fall on outstretched arms, 15 cases of direct trauma to the shoulders and upper arms, and 8 cases of traction injury of the upper limbs (Table 1).
We excluded patients with disorders such as diabetes or thyroid disease, which can induce peripheral neuropathy; cervical lesions such as cervical disc herniation or spinal stenosis, as diagnosed by magnetic resonance imaging; and rotator cuff disorders or shoulder impingement syndrome. We included 142 patients of the selected patients for the analysis. Three cases of TOS were idiopathic.

데이터처리

These VAS scores were calculated from the results of pre-injection VAS scores minus post-injection VAS score. We also used a paired t-test to evaluate the differences in VAS scores, calculated from pre-injection VAS scores minus post-injection VAS scores.

성능/효과

Injections were also repeated if there was tenderness in the ipsilateral shoulder near the neck after the procedure. After completion of the procedure, patients remained under observation for approximately 30 minutes to monitor for acute complications such as seizure, dyspnea, or altered mental status.

참고문헌 (20)

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상세보기
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상세보기
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상세보기
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상세보기
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상세보기
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원문보기 상세보기
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상세보기
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상세보기
Shenkin HA, Somach FM : Scalenotomy in patients with and without cervical ribs; analysis of surgical results. Arch Surg 87 : 892-896, 1963

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The Efficacy of Scalene Injection in Thoracic Outlet Syndrome 원문보기

Abstract ▼ AI-Helper

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문제 정의

제안 방법

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데이터처리

성능/효과

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The Efficacy of Scalene Injection in Thoracic Outlet Syndrome 원문보기

Abstract ▼ AI-Helper

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제안 방법

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참고문헌 (20)

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