{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:57:18Z","timestamp":1784696238636,"version":"3.55.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"8","license":[{"start":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T00:00:00Z","timestamp":1708300800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,19]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The optimal surgical approach to treat neurogenic thoracic outlet syndrome (nTOS) depends on the individual patient\u2019s anatomy as well as the surgeon\u2019s experience. The authors present a minimally invasive posterior approach for the resection of a prominent transverse process to reduce local muscular trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 19-year-old female presented with painful sensations in the right arm and severe fine-motor skill dysfunction in the right hand, each of which had been present for several years. Further examination confirmed affected C8 and T1 areas, and imaging showed an elongated C7 transverse process displacing the lower trunk of the brachial plexus. Decompression of the plexus structures by resection of the C7 transverse process was indicated, owing to persistent neurological effects. Surgery was performed using a minimally invasive posterior approach in which the nuchal soft tissue was bluntly dissected by dilatators and resection of the transverse process was done microscopically through a tubular retractor. The postoperative course showed a sufficient reduction of pain and paresthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The authors describe a minimally invasive posterior approach for the treatment of nTOS with the aim of providing indirect relief of strain on brachial plexus structures. The advantages of this technique include a small skin incision and minor soft tissue damage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23474","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T19:47:43Z","timestamp":1708372063000},"source":"Crossref","is-referenced-by-count":2,"title":["Minimally invasive resection of a prominent transverse process in neurogenic thoracic outlet syndrome: new application for a primarily spinal approach. Illustrative case"],"prefix":"10.3171","volume":"7","author":[{"given":"Marc","family":"Hohenhaus","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Lambeck","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurophysiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nico","family":"Kremers","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Beck","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Scholz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Hubbe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"Praxis (Bern)","first-page":"391","article-title":"Thoracic outlet syndrome: rare, often missed or over-diagnosed?","volume":"110","author":"Dorn P","year":"2021","unstructured":"Dorn P, Zehnder A, Kocher GJ Thoracic outlet syndrome: rare, often missed or over-diagnosed? Article in German. Praxis (Bern). 2021;110(7):391\u2013396."},{"issue":"1","key":"b2","series-title":"Pain Ther","first-page":"5","article-title":"Thoracic outlet syndrome: a comprehensive review of pathophysiology, diagnosis, and treatment","volume":"8","author":"Jones MR","year":"2019","unstructured":"Jones MR, Prabhakar A, Viswanath O,  Thoracic outlet syndrome: a comprehensive review of pathophysiology, diagnosis, and treatment. Pain Ther. 2019;8(1):5\u201318."},{"key":"b3","series-title":"Ann Vasc Surg","first-page":"454","article-title":"Diagnosis of neurogenic thoracic outlet syndrome based on the clinical status","volume":"76","author":"Hwang JS","year":"2021","unstructured":"Hwang JS, Kim J, Kim S, Bae KJ, Lee Y, Baek GH Diagnosis of neurogenic thoracic outlet syndrome based on the clinical status. Ann Vasc Surg. 2021;76:454\u2013462."},{"issue":"3","key":"b4","series-title":"Neurosurg Focus","first-page":"E7","article-title":"A modified, less invasive posterior subscapular approach to the brachial plexus: case report and technical note","volume":"42","author":"Crutcher CL 2nd","year":"2017","unstructured":"Crutcher CL 2nd, Kline DG, Tender GC A modified, less invasive posterior subscapular approach to the brachial plexus: case report and technical note. Neurosurg Focus. 2017;42(3):E7."},{"issue":"1","key":"b5","series-title":"Arthrosc Tech","first-page":"e235","article-title":"Endoscopic-assisted transaxillary approach for first-rib resection and neurolysis in thoracic outlet syndrome","volume":"10","author":"Furushima K","year":"2021","unstructured":"Furushima K, Funakoshi T Endoscopic-assisted transaxillary approach for first-rib resection and neurolysis in thoracic outlet syndrome. Arthrosc Tech. 2021;10(1):e235\u2013e240."},{"issue":"10","key":"b6","series-title":"J Thorac Dis","first-page":"6141","article-title":"Robotic first rib resection for thoracic outlet syndrome","volume":"13","author":"Gharagozloo F","year":"2021","unstructured":"Gharagozloo F, Atiquzzaman N, Meyer M, Tempesta B, Werden S Robotic first rib resection for thoracic outlet syndrome. J Thorac Dis. 2021;13(10):6141\u20136154."},{"issue":"11","key":"b7","series-title":"Cochrane Database Syst Rev","first-page":"CD007218","article-title":"Treatment for thoracic outlet syndrome","author":"Povlsen B","year":"2014","unstructured":"Povlsen B, Hansson T, Povlsen SD Treatment for thoracic outlet syndrome. Cochrane Database Syst Rev. 2014;(11):CD007218."},{"issue":"6","key":"b8","series-title":"Neurology","first-page":"1252","article-title":"Outcome of surgery for thoracic outlet syndrome in Washington state workers\u2019 compensation","volume":"54","author":"Franklin GM","year":"2000","unstructured":"Franklin GM, Fulton-Kehoe D, Bradley C, Smith-Weller T Outcome of surgery for thoracic outlet syndrome in Washington state workers\u2019 compensation. Neurology. 2000;54(6):1252\u20131257."},{"issue":"5","key":"b9","series-title":"Surgery","first-page":"840","article-title":"Long-term outcome after transaxillary approach for thoracic outlet syndrome","volume":"118","author":"Mingoli A","year":"1995","unstructured":"Mingoli A, Feldhaus RJ, Farina C,  Long-term outcome after transaxillary approach for thoracic outlet syndrome. 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Innovations (Phila). 2012;7(1):39\u201344."},{"issue":"1","key":"b13","series-title":"Ann Thorac Surg","first-page":"241","article-title":"Totally endoscopic (VATS) first rib resection for thoracic outlet syndrome","volume":"103","author":"George RS","year":"2017","unstructured":"George RS, Milton R, Chaudhuri N, Kefaloyannis E, Papagiannopoulos K Totally endoscopic (VATS) first rib resection for thoracic outlet syndrome. Ann Thorac Surg. 2017;103(1):241\u2013245."},{"key":"b14","series-title":"World Neurosurg","first-page":"219","article-title":"Minimally invasive resection of symptomatic cervical rib for treatment of thoracic outlet syndrome","volume":"139","author":"Hawks C","year":"2020","unstructured":"Hawks C, Herrera-Nicol S, Pruzansky ME, Jenkins AL 3rd. Minimally invasive resection of symptomatic cervical rib for treatment of thoracic outlet syndrome. 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World Neurosurg. 2020;140:622\u2013626."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/7\/8\/article-CASE23474.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/7\/8\/article-CASE23474.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/7\/8\/article-CASE23474.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:24:40Z","timestamp":1770301480000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/7\/8\/article-CASE23474.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,19]]},"references-count":30,"journal-issue":{"issue":"8"},"URL":"https:\/\/doi.org\/10.3171\/case23474","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,19]]}}}