{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:03:23Z","timestamp":1790391803372,"version":"4.1.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Post-traumatic neurogenic thoracic outlet syndrome remains an underreported condition, particularly in high-trauma and resource-limited settings. This study aimed to characterize the clinical presentation of post-traumatic neurogenic thoracic outlet syndrome and evaluate functional outcomes, recurrence, and factors associated with outcomes following surgical decompression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 400 consecutive patients with post-traumatic neurogenic thoracic outlet syndrome who underwent supraclavicular thoracic outlet decompression between 2007 and 2024. Patients with arterial or venous thoracic outlet syndrome were excluded. All patients underwent first-rib resection with anterior and middle scalenectomy and excision of associated anomalous osseous structures when present. Functional outcomes were assessed using the disabilities of the arm, shoulder, and hand score. Recurrence-free survival was evaluated using Kaplan\u2013Meier analysis, and multivariable regression was used to identify factors associated with recurrence and functional improvement. The follow-up duration ranged from 24 to 60 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean participant age was 36.1\u2009\u00b1\u20099.5 years, and 255 patients (63.7%) were women. Falls from height (27.3%), physical assault (26.0%), pedestrian injury (24.8%), and road traffic accidents (22.0%) were the principal trauma mechanisms. Cervical ribs were present in 37.0% and elongated transverse processes in 30.8% of the study participants. The mean disabilities of the arm, shoulder, and hand score decreased from 54.8\u2009\u00b1\u20099.0 preoperatively to 9.8\u2009\u00b1\u20096.0 postoperatively (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). During follow-up, 120 patients (30.0%) developed recurrence. Cervical rib was associated with increased recurrence (odds ratio: 1.50, 95% confidence interval: 1.05\u20132.10;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02) and less functional improvement (\u03b2 = \u22122.1;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04). Pneumothorax requiring chest-tube drainage occurred in 2.0%; no major neural or vascular injuries or perioperative deaths were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this retrospective cohort, supraclavicular decompression was associated with substantial functional improvement in selected patients with persistent post-traumatic neurogenic thoracic outlet syndrome. Cervical rib may be associated with recurrence and less favorable functional recovery. Prospective multicenter studies are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605261488728","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:55:53Z","timestamp":1790070953000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Post-traumatic neurogenic thoracic outlet syndrome: Clinical presentation and surgical outcomes\u2013A retrospective cohort study"],"prefix":"10.1177","volume":"54","author":[{"given":"Mohammed Yassin","family":"Rasul","sequence":"first","affiliation":[{"name":"College of Medicine, University of Sulaimani, Sulaimani Shar Teaching Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bawan Bakr","family":"Wahab","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Sulaimani, Sulaimani Shar Teaching Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ako Nooralddin","family":"Abdalla","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Sulaimani, Sulaimani Shar Teaching Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9217-1189","authenticated-orcid":false,"given":"Aram","family":"BARAM","sequence":"additional","affiliation":[{"name":"College of Medicine, Branch of Clinical sciences, University of Sulaimani, Sulaimani Shar Teaching Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/tomography10090103"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-011-1269-x"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10016-004-0151-1"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12216811"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.20408\/jti.2023.0081"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2022.05.003"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0218492313489840"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2007.07.013"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1538574411434164"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1558944720988079"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.11.039"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2023.0002"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.03.029"},{"key":"e_1_3_3_16_2","doi-asserted-by":"crossref","unstructured":". Wagner ER Sullivan CM Cuneo KR et al. Defining diagnostic criteria for neurogenic thoracic outlet syndrome: an expert consensus. Orthop J Sports Med 2026; 14: 23259671261440925.","DOI":"10.1177\/23259671261440925"},{"key":"e_1_3_3_17_2","article-title":"Clinical characteristics and surgical outcomes in thoracic outlet syndrome: a comparative study of cases with and without cervical rib","volume":"40","author":"Ali AN","year":"2025","unstructured":"Ali AN, ElSobky H, Abou El-Magd E-S, et al. Clinical characteristics and surgical outcomes in thoracic outlet syndrome: a comparative study of cases with and without cervical rib. Egypt J Neurosurg 2025; 40: 9\u201311.","journal-title":"Egypt J Neurosurg"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.02.096"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1708538121997332"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.5761\/atcs.oa.23-00110"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2016150221"},{"key":"e_1_3_3_22_2","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-023-06762-7","article-title":"Diagnosis of thoracic outlet syndrome with the lower trunk compression of brachial plexus by high-frequency ultrasonography","volume":"24","author":"Chen D","year":"2023","unstructured":"Chen D, Gong W, Wang J, et al. Diagnosis of thoracic outlet syndrome with the lower trunk compression of brachial plexus by high-frequency ultrasonography. 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