Five percent of cases are venous. Arterial TOS occurs when an artery is compressed. Only about 1 percent of cases are arterial. Sometimes, the venous and arterial syndromes are known together as vascular thoracic outlet syndrome. What is Thoracic Outlet Syndrome, How is it Diagnosed and Treated Assistant professor of surgery and vascular surgeon Ying Wei Lum discusses causes, symptoms and risk factors of thoracic outlet syndrome. What are the symptoms of thoracic outlet syndrome? The symptoms of thoracic outlet syndrome depend on the type of TOS. Symptoms of Neurogenic Thoracic Outlet Syndrome Pain or weakness in the shoulder and arm Tingling or discomfort in the fingers Arm that tires quickly Atrophy — shrinking and weakness — of the pad of the thumb, the muscle of the palm that leads to the thumb; this is quite rare Symptoms may come and go, but they are often made worse when arms are held up. The longer the arms stay up, the worse the symptoms can get. Symptoms of Venous Thoracic Outlet Syndrome Edema (swelling) of the arm, hand or fingers Blueness of the hand and arm Painful tingling in the hand and arm Very prominent veins in the shoulder, neck and hand These symptoms occur because compression of the vein may cause blood clots.
Our neurological anatomy should be understood to account for the variety of symptoms produced by spinal stenosis. Our spinal cord is a solid structure approximately one centimeter (3/8") in diameter. The spinal cord extends through the cervical and thoracic regions extending to the junction of the thoracic and lumbar spine. In the lumbar spine, the neurological structures are basically individual nerves travelling within the spinal canal and referred to as the cauda equina. Related to the fact that the spinal cord and spinal nerves are different anatomical structures, the symptoms of spinal cord compression and spinal nerve compression are different. Let's review the symptoms of spinal stenosis for each region of the spine. Symptoms and Treatment of Lumbar Stenosis Lumbar spinal stenosis is the most common form of spinal stenosis. Patients generally find themselves comfortable when seated and usually also when lying down. Pain is exacerbated by standing and walking and will usually start in the low back or buttock region and then radiate to one or both lower extremities.
Injections of local anesthetics and steroids are very effective in the treatment of pain in cervicothoracic bursitis, which could not be alleviated by other conservative measures. Strong exercises should be avoided, as they can aggravate the symptoms. [ 10], [ 11], [ 12], [ 13], [ 14], [ 15], [ 16] Treatment of cervicothoracic interstitial bursitis In the treatment of cervical-thoracic interstitial bursitis, a multi-level approach is most effective. Physiotherapy, consisting of correction of functional abnormalities (incorrect posture, improper stool or computer height), thermal procedures and deep relaxing massage in combination with NSAIDs (eg diclofenac or lornoxicam) and muscle relaxants (eg, tizanidine) are appropriate at the beginning of treatment. If this treatment does not provide rapid relief of pain, the next step is to inject the local anesthetic and steroid into the area between the interstitial and yellow ligaments. For symptomatic relief, cervical epidural blockades, blockages of the medial branch of the dorsal nerve or intraarticular injection into the facet joint of local anesthetics and steroids can be used.
Spinal nerves can become inflamed due to irritation from a damaged disc or from contact with a bone spur.
And that's a good thing most of the time. On the downside, the highly flexible neck makes it especially vulnerable to injury—such as whiplash when your head is thrust forward due to impact from a rear-end auto crash. Thoracic Spine This is your rib-cage/midback area and it has 12 vertebrae (T1–T12). Unlike your other vertebrae, these attach to your ribs. The thoracic spine can move forward relatively easily, though it's much more limited bending backward. This part of your back is not typically a huge problem when it comes to back pain(most problems occur in the lower back). The midback can, however, be overly curved in some individuals, a condition called kyphosis. It often results from bad posture—think of slouching teenagers. But it can also be caused by disease. Either way, the excessive curve makes a person appear hunchbacked. There can be some discomfort with kyphosis caused by disease, but postural kyphosis doesn't generally cause much pain. However, excessively rounding your thoracic spine may also lead to the head being positioned forward, which, as we mentioned earlier, causes problems in your neck.
This is known as effort thrombosis, or Paget-Schroetter syndrome. Effort thrombosis is a type of deep vein thrombosis. In this case, the clots are formed as the result of overhead motions (efforts) that compress the vein. Deep vein thrombosis is more common in the legs. When it occurs in the shoulders or arms, the cause is either recent surgery, a foreign object inserted into the upper body — such as a central line, pacemaker or implantable cardioverter defibrillator — or thoracic outlet syndrome. Symptoms of Arterial Thoracic Outlet Syndrome Cold and pale hand Pain in the hand and arm, especially during overhead motions of the arm Embolism (blockage) of an artery in the hand or arm Aneurysm of the subclavian artery What causes thoracic outlet syndrome? Sometimes, a congenital (from birth) abnormality can cause thoracic outlet syndrome, but it is more likely to occur after injury or bodybuilding. Specifically: Cervical rib: A cervical rib is an extra rib that grows from the cervical spine — the neck part of the spine.
The study of the radioanatomy of the thoracic spine is composed of two different standard radiographic plates: the impact from the front (anterior) and profile (posterior). These X-rays show the vertebral bodies of thoracic vertebrae, the spinous, transverse and articular processes as well as the costovertebral and zygapophysial joints. [UMLS:C0012249], Vertebral column, Thoracic vertebrae [TI-TXII]: Anterior-posterior view Radiological anatomy of the lumbar spine: The anteroposterior radiograph (anterior aspect) shows the vertebral bodies of five lumbar vertebrae, their transverse processes, spinous and upper and lower joints. Lumbar vertebrae [LI-LV], Anatomy: [UMLS:C0012249] The lateral radiograph (side aspect) of the lumbar spine shows the vertebral bodies and intersomatic spaces, the intervertebral faces of the vertebral bodies and laminae of the vertebral arch. It displays the lumbar intervertebral foramina and pedicles perfectly. The three-quarters radiograph (oblique lumbar spine aspect) is particularly useful for identifying the zygapophysial (facet) joints, the pedicles and the superior and inferior articular processes, which form the classic "little dog" radiographic aspect.