Paresis of Nervus Thoracicus Longus after Resection of the Right Rib  in the Thoracic Outlet Syndrome

Overview

According to Woody the paresis of n. thoracicus longus after resection of the right rib from the transaxillar approach in cases of thoracic outlet syndrome is the second most frequent complication (8). In our report we resent the case of a 32 years old woman with thoracic outlet syndrome on the right with subsequent thrombosis of v. subclavia, v. axillaris, and v. brachialis after mechanical thrombectomy and local thrombolysis, after introduction of endovascular stent into v. subclavia on the right and after transaxillar resection of the right rib on the right, where postoperative paresis of n. thoracicus longus developed on the right. After a complex rehabilitation therapy in the course of five months a complete adjustment of the paresis developed. In addition to the exercise directed to the activity of shoulder humeral muscles and scapula stabilization it is necessary to adjust correct breathing and side trunk stabilizers, which form punctum fixum for m. serratus anterior. The indispensable part of a complex therapy is electric stimulation of n. thoracicus longus. The aligning shoulder band proved to be useful during the treatment.

Keywords:
paresis of n. thoracicus longus, resection of the right rib in thoracic outlet syndrome, m. serratus anterior, rehabilitation of n. thoracicus longus paresis