D153. Patient Reported Outcomes After Surgical Treatment for Neurogenic Thoracic Outlet Syndrome With At Least 1 Year Follow-up

PURPOSE: Neurogenic thoracic outlet syndrome (NTOS) is an uncommon condition with limited consensus on best methods for diagnosis and treatment. METHODS: Forty-four consecutive patients who underwent surgery for NTOS were reviewed. Patients were contacted at least one year postoperatively and assessed using standardized patient-reported outcome measures (PROMs), including Visual Analog Scale (VAS) for pain, Patient Satisfaction Scale (PSS), Derkash classification, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Michigan Hand Outcomes Questionnaire (MHQ), and Cervical Brachial Symptom Questionnaire (CBSQ). Data were analyzed using t-tests and linear regression models. RESULTS: The NTOS site of involvement was supraclavicular (SC) in 12 (27.3%) patients, infraclavicular (IC) in 16 (36.4%), and both (SC and IC) in 16 (36.4%). A distal compression site was treated in 20 (45.5%) patients. Overall success rate as assessed through Derkash classification was 87.5%. Mean postoperative VAS score (2.6±3.2) was significantly improved from preoperative VAS score (8.0±2.9). Mean postoperative DASH, MHQ and CBSQ scores were 32.8±21.8, 68.1±26.5 and 39.2±32.6, respectively. Worse postoperative VAS scores were significantly (p<0.05) correlated with poorer outcomes (Derkash, DASH, MHQ and CBSQ scores). Multiple linear regression analysis showed that surgical delay was the most significant factor for a higher mean postoperative VAS pain score. CONCLUSION: Surgical delay for NTOS was associated with higher postoperative VAS pain scores suggesting that earlier surgical intervention in patients diagnosed with NTOS following recommended guidelines, may be beneficial. Higher VAS scores were significantly correlated with poorer postoperative mid-term outcomes as assessed through the DASH, MHQ, CBSQ scores, and Derkash classification.