I’ll clarify a bit about TOS. This is a very common syndrome, especially in baseball players. It rarely occurs due to anomaly of an additional rib or moderate(inborn) small thoracic outlet. TOS often occurs due to physical exertion and occupational diseases, like a violinist, baseball player, etc. who often raise their hands and are tense. Improper posture can also cause and lead to TOS disease.
Many surgeons operate on TOS, but they have a different approach and method. There are 4 surgical approaches in total (above and below the collarbone incision, armpit, and posterior access.) We have about 10 surgeons in Russia who are engaged in TOS. Surgery is performed in different ways. Someone cuts off only the anterior scalene muscle, others cut it off and partially resect it, as there have been cases of its regrowth.Other surgeons remove part of the first rib or an additional cervical rib (rib removal has a greater effect, but it is more difficult). There were also cases of the 1st rib growing back, relapses ( and also the front part of the first rib remains (where the shoulder blade of the sternum is). Which can cause compression of the veins.). Therefore, Dr. Agaev removes the first rib completely, and cuts off 3 scalenus muscles.
Some patients benefit from special physical exercises. And never rush into a surgical operation (don’t rush, think it over, get examined — diagnose in more detail). There’s a saying: measure seven times, cut once.
The main one is neurogenic TOS, which is compression of the brachial plexus of nerves. In 90% of TOS cases, it is a neurogenic type. Symptoms of the neurogenic type are numbness of the fingers / tingling, weakness in the arm, pain in the shoulder and neck (tension of the neck and shoulder muscles / pain in the arm and neck).There is a particular tingling sensation in the fingers during certain hand movements and physical exertion.
So we know that 90% of TOS is of the neurogenic type (it’s just arm numbness). The remaining 10% of cases are divided into venous type, arterial type and mixed type.
There is also a vascular type of TOS (there is also a mixed type). The venous type is when the subclavian vein or, rarely, the mouth, the source(beginning) of the IJV and VV on subclavian vein are clamped/compressed (But this is not a common phenomenon, though it does occur. They may not be compressed on a permanent basis, but periodically, or partially compressed.). There is also subclavian vein thrombosis and its further spread and complete blockage of the vein (this is due to mechanical damage). The venous type of TOS is about 6% out of 10%. Symptoms : cyanosis of the arm, swollen arm, weakness in the arm. (this does not apply to the mouths/sources of the IJV). There are collateral veins in your arm, workarounds, you may have a subclavian vein compressed, but there will be no significant blueness in your arm (or partial compression). The IJVs also maybe compressed between the anterior scalene muscle and the SCM.
Arterial type of TOS is 1-2% . In this case, the subclavian artery is compressed between the middle and anterior scalenus muscles, and there may also be an aneurysm. It is extremely rare for TOS to affect the vertebral artery (these are some isolated cases).
The remaining 2-3% is a mixed type.
Some surgeons also claim that the scalene muscles can compress the stellate nerve or the vagus nerve (but this is an extremely controversial statement. In fact, it is highly questionable. Perhaps such cases do exist, but only in isolated instances).
The articles may contain errors, and you may have missed something; you shouldn’t take medical articles as 100 % reliable.
I can’t post links, so I asked another user to post links to my TOS articles. There are a lot of them about 100