Stephanie D Talutis, Jesus G Ulloa, Sharon L Hame, Hugh A Gelabert
{"title":"Non-Surgical Care of Neurogenic Thoracic Outlet Syndrome in a NCAA Division 1 Athletic Conference.","authors":"Stephanie D Talutis, Jesus G Ulloa, Sharon L Hame, Hugh A Gelabert","doi":"10.1016/j.avsg.2025.07.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Thoracic outlet syndrome (TOS) is a disabling condition which may end an athletic career. While physical therapy is the initial treatment for TOS, there is a paucity of management outcomes data. Our goal is to report the outcome of non-surgical care in a NCAA Division 1 athletic conference.</p><p><strong>Methods: </strong>The prospectively maintained PAC-12 Health Analytics Program Database was searched for athletes with TOS from 2016-2022. Athletes with neurogenic (NTOS) diagnosis were identified. Outcomes of non-surgical care were analyzed according to success of physical therapy alone, need for specialty consultation and interventional procedures. Analysis compared non-surgical and surgical management.</p><p><strong>Results: </strong>15,609 athletes (6,874 men and 8,735 women) in 21 sports were registered. TOS was identified in 76 (0.48%) athletes: 69 (90.8%) NTOS. All 69 athletes with NTOS were initially managed with non-surgical modalities. Ultimately, this failed in 9 (13%), who required surgery. Non-surgical care included physical therapy 69 (100%), subspecialty consultation in 48 (69%), and interventional procedures in 5 (7%). Of the 69 athletes with NTOS, 55 (79.7%) experienced compete resolution of symptoms and 14 (20%) noted partial resolution. Physical therapy alone was used to treat 21 athletes, 17 (81%) of these noted complete resolution of symptoms. Of the 48 who required specialty consultation complete resolution of symptoms was noted in 48 (79.2%). Interventional procedures were used to treat 5, and 3 (60%) noted complete symptom resolution. Of the 60 athletes managed with non-surgical care complete resolution of symptoms was noted in 81.7%, whereas surgical decompression resulted in resolution of symptoms in 66.7% of athletes. All athletes returned to competition: 95% returned to unrestricted competition, and 5% with some restriction. This included 96.2% of NTOS managed without surgery and 85.7% of NTOS managed surgically.</p><p><strong>Conclusion: </strong>This report details outcomes of non-surgical care of TOS in a Division 1 NCAA Collegiate Conference based on a prospective, conference-wide database. The majority (84%) of athletes were managed with non-surgical care. This was successful with resolution of symptoms in 93% and unrestricted return to competition in 96%. Non-surgical care is successful and provides effective resolution of TOS symptoms for most elite collegiate athletes.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.avsg.2025.07.017","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Thoracic outlet syndrome (TOS) is a disabling condition which may end an athletic career. While physical therapy is the initial treatment for TOS, there is a paucity of management outcomes data. Our goal is to report the outcome of non-surgical care in a NCAA Division 1 athletic conference.
Methods: The prospectively maintained PAC-12 Health Analytics Program Database was searched for athletes with TOS from 2016-2022. Athletes with neurogenic (NTOS) diagnosis were identified. Outcomes of non-surgical care were analyzed according to success of physical therapy alone, need for specialty consultation and interventional procedures. Analysis compared non-surgical and surgical management.
Results: 15,609 athletes (6,874 men and 8,735 women) in 21 sports were registered. TOS was identified in 76 (0.48%) athletes: 69 (90.8%) NTOS. All 69 athletes with NTOS were initially managed with non-surgical modalities. Ultimately, this failed in 9 (13%), who required surgery. Non-surgical care included physical therapy 69 (100%), subspecialty consultation in 48 (69%), and interventional procedures in 5 (7%). Of the 69 athletes with NTOS, 55 (79.7%) experienced compete resolution of symptoms and 14 (20%) noted partial resolution. Physical therapy alone was used to treat 21 athletes, 17 (81%) of these noted complete resolution of symptoms. Of the 48 who required specialty consultation complete resolution of symptoms was noted in 48 (79.2%). Interventional procedures were used to treat 5, and 3 (60%) noted complete symptom resolution. Of the 60 athletes managed with non-surgical care complete resolution of symptoms was noted in 81.7%, whereas surgical decompression resulted in resolution of symptoms in 66.7% of athletes. All athletes returned to competition: 95% returned to unrestricted competition, and 5% with some restriction. This included 96.2% of NTOS managed without surgery and 85.7% of NTOS managed surgically.
Conclusion: This report details outcomes of non-surgical care of TOS in a Division 1 NCAA Collegiate Conference based on a prospective, conference-wide database. The majority (84%) of athletes were managed with non-surgical care. This was successful with resolution of symptoms in 93% and unrestricted return to competition in 96%. Non-surgical care is successful and provides effective resolution of TOS symptoms for most elite collegiate athletes.
期刊介绍：
Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal:
Clinical Research (reports of clinical series, new drug or medical device trials)
Basic Science Research (new investigations, experimental work)
Case Reports (reports on a limited series of patients)
General Reviews (scholarly review of the existing literature on a relevant topic)
Developments in Endovascular and Endoscopic Surgery
Selected Techniques (technical maneuvers)
Historical Notes (interesting vignettes from the early days of vascular surgery)
Editorials/Correspondence
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