Systematic bifocal decompression for isolated long thoracic nerve paresis: A case series of 12 patients
To date, no consensus exists regarding the best surgical management of isolated, micro-traumatic long thoracic nerve (LTN) paresis. Our hypothesis was that a combined decompression of the LTN at two potential locations for entrapment would be effective in the management of dynamic LTN paresis. We re...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-03-01
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| Series: | Interdisciplinary Neurosurgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751921002966 |
| _version_ | 1818572732714975232 |
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| author | Leonard Achenbach Malo Le Hanneur Roland S. Camenzind Michael Bouyer Pierre Pottecher Thibault Lafosse |
| author_facet | Leonard Achenbach Malo Le Hanneur Roland S. Camenzind Michael Bouyer Pierre Pottecher Thibault Lafosse |
| author_sort | Leonard Achenbach |
| collection | DOAJ |
| description | To date, no consensus exists regarding the best surgical management of isolated, micro-traumatic long thoracic nerve (LTN) paresis. Our hypothesis was that a combined decompression of the LTN at two potential locations for entrapment would be effective in the management of dynamic LTN paresis. We report on twelve patients with isolated LTN parersis, with tenderness at two entrapment sites, who underwent bifocal LTN decompression after undergoing unsuccessful conservative treatment for at least 6 months; all patients had preoperative electrodiagnostic studies that confirmed the paresis and ruled out peripheral neuritis. Clinical and electrical improvements were observed in eight patients (67%) regarding shoulder flexion, shoulder abduction, and Quick-DASH scores. Four patients (33%) did not improve after surgery. The results corroborate our hypothesis that a bifocal LTN decompression can be an effective and reliable therapeutic option in more than half of a very selective patient population suffering from serratus anterior muscle deficiency. |
| first_indexed | 2024-12-15T00:01:34Z |
| format | Article |
| id | doaj.art-30466f82b42c4d82bc742df9488c2aa2 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-15T00:01:34Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-30466f82b42c4d82bc742df9488c2aa22022-12-21T22:42:53ZengElsevierInterdisciplinary Neurosurgery2214-75192022-03-0127101384Systematic bifocal decompression for isolated long thoracic nerve paresis: A case series of 12 patientsLeonard Achenbach0Malo Le Hanneur1Roland S. Camenzind2Michael Bouyer3Pierre Pottecher4Thibault Lafosse5Hand, Upper Limb, Brachial Plexus, and Microsurgery Unit (PBMA), Clinique Générale d’Annecy, Annecy, France; Dpt. of Orthopedics, König-Ludwig-Haus, Julius-Maximilians-University Wuerzburg, Wuerzburg, Germany; Corresponding author at: Dpt. of Orthopedics, König-Ludwig-Haus, Julius-Maximilians-University Würzburg, Brettreichstraße 11, 97074 Würzburg, Germany.Hand to Shoulder Mediterranean Center, ELSAN, Clinique Bouchard, Marseille, FranceHand, Upper Limb, Brachial Plexus, and Microsurgery Unit (PBMA), Clinique Générale d’Annecy, Annecy, France; Dpt. of Orthopedics, University of Zurich, Balgrist University Hospital, Zurich, SwitzerlandHand, Upper Limb, Brachial Plexus, and Microsurgery Unit (PBMA), Clinique Générale d’Annecy, Annecy, FranceDpt. of Radiology, Clinique Générale d’Annecy, Annecy, FranceHand, Upper Limb, Brachial Plexus, and Microsurgery Unit (PBMA), Clinique Générale d’Annecy, Annecy, FranceTo date, no consensus exists regarding the best surgical management of isolated, micro-traumatic long thoracic nerve (LTN) paresis. Our hypothesis was that a combined decompression of the LTN at two potential locations for entrapment would be effective in the management of dynamic LTN paresis. We report on twelve patients with isolated LTN parersis, with tenderness at two entrapment sites, who underwent bifocal LTN decompression after undergoing unsuccessful conservative treatment for at least 6 months; all patients had preoperative electrodiagnostic studies that confirmed the paresis and ruled out peripheral neuritis. Clinical and electrical improvements were observed in eight patients (67%) regarding shoulder flexion, shoulder abduction, and Quick-DASH scores. Four patients (33%) did not improve after surgery. The results corroborate our hypothesis that a bifocal LTN decompression can be an effective and reliable therapeutic option in more than half of a very selective patient population suffering from serratus anterior muscle deficiency.http://www.sciencedirect.com/science/article/pii/S2214751921002966Entrapment, tractionSerratus anteriorScapular wingingScapula alataDyskinesiaPeripheral nerve |
| spellingShingle | Leonard Achenbach Malo Le Hanneur Roland S. Camenzind Michael Bouyer Pierre Pottecher Thibault Lafosse Systematic bifocal decompression for isolated long thoracic nerve paresis: A case series of 12 patients Interdisciplinary Neurosurgery Entrapment, traction Serratus anterior Scapular winging Scapula alata Dyskinesia Peripheral nerve |
| title | Systematic bifocal decompression for isolated long thoracic nerve paresis: A case series of 12 patients |
| title_full | Systematic bifocal decompression for isolated long thoracic nerve paresis: A case series of 12 patients |
| title_fullStr | Systematic bifocal decompression for isolated long thoracic nerve paresis: A case series of 12 patients |
| title_full_unstemmed | Systematic bifocal decompression for isolated long thoracic nerve paresis: A case series of 12 patients |
| title_short | Systematic bifocal decompression for isolated long thoracic nerve paresis: A case series of 12 patients |
| title_sort | systematic bifocal decompression for isolated long thoracic nerve paresis a case series of 12 patients |
| topic | Entrapment, traction Serratus anterior Scapular winging Scapula alata Dyskinesia Peripheral nerve |
| url | http://www.sciencedirect.com/science/article/pii/S2214751921002966 |
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