Dr. Nguyen Anh Dung, Head of the Department of Thoracic and Vascular Surgery at Tam Anh General Hospital in TP HCM, explains that thoracic outlet syndrome (TOS) is a rare congenital anatomical abnormality. It occurs when nerves or blood vessels are compressed by the ribs, collarbone, or muscles at the top of the thoracic outlet. In younger individuals, the muscles are more flexible, and the nerve compression is less pronounced, so the condition may not manifest. As people age, muscles can stiffen and degenerate, leading to nerve compression. Symptoms become more apparent in individuals engaged in manual labor or those whose work involves frequent shoulder movements, often mistaken for musculoskeletal disorders.

Three years ago, Hien began experiencing numbness and weakness in her right hand. Treatment for spinal degeneration proved ineffective. Recently, she developed muscle atrophy and decreased mobility. She was then diagnosed with TOS and sought treatment at Tam Anh General Hospital in TP HCM.

Dr. Dung stated that Hien's condition was neurogenic TOS (nTOS), the most common type (95%), characterized by compression of the brachial plexus. This network of nerves originating from the spinal cord controls movement and sensation in the shoulder, arm, and hand. The other two types are venous TOS (vTOS) and arterial TOS (aTOS).

The surgical team removed surrounding tissue and muscle and cut the anterior scalene muscle to widen the thoracic outlet.

Dr. Dung (right) and the surgical team operating on the patient. Photo illustration: Thanh Luan

One day after surgery, Hien's numbness subsided, and she regained normal function. She received physiotherapy to restore mobility in her hand and was discharged after three days, with scheduled follow-up appointments and regular physiotherapy.

According to Dr. Dung, besides anatomical abnormalities, TOS can result from prolonged poor posture, such as slumped shoulders and a forward-leaning head, which compress the thoracic outlet. Other contributing factors include injuries, carrying heavy objects, and obesity. Individuals at higher risk include athletes, mechanics, hairdressers, teachers, assembly line workers, and those involved in heavy lifting.

TOS typically manifests between the ages of 20 and 50 and is more common in women. To reduce the risk, Dr. Dung recommends maintaining good posture (keeping shoulders and head straight, minimizing prolonged forward head posture), taking regular breaks at work to move and stretch, maintaining a healthy weight, avoiding carrying heavy objects on the shoulders, and practicing relaxation techniques such as deep breathing, meditation, and stretching.

Thu Ha

*The patient's name has been changed.