Diagnosis and Management of Thoracic Outlet Syndrome and

Cervicothoracic Junction Pain

This IAOM-US course is appropriate for ATs, OTs, PT’s and PTA’s.  The IAOM-US teaches that the essential starting point for orthopedic care is accurate clinical diagnosis.  IAOM courses and resources present effective manual orthopedic techniques established by leaders in the field.  Scientific and clinical research provides the foundation for the entire program.

Psst!  Hi!  This list will automatically update as you update the progress on the various modules. If you click these objectives, nothing will happen. 

1Cervicothoracic Junction Pathoanatomy and Pathomechanics
2Cervicothoracic Junction Biomechanics
3Thoracic Outlet Syndrome Pathoanatomy I
4Thoracic Outlet Syndrome Pathoanatomy II
5Cervicothoracic Junction Neurology Considerations Part I
6Cervicothoracic Junction Neurology Considerations Part II
7Thoracic Outlet Syndrome Clinical Exam and Diagnosis
8Thoracic Outlet Syndrome Clinical Exam, Diagnosis and Management
9Cervicothoracic Junction Clinical Exam and Management Suggestions Part I
10Cervicothoracic Junction Clinical Exam and Management Suggestions Part II
11Cervicothoracic Junction Clinical Exam and Management Suggestions Part III
12CTJ TOS Joint-Specific Mobilization of Shoulder Girdle and Glenohumeral Joint
13CTJ TOS Differential Diagnosis and Management Suggestions for T-4 Syndrome
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“Mechanical Tension in the Median Nerve – The Effects of Joint Positions,” by Geert Jan Kleinrensink, an anatomist from Erasmus University in Rotterdam, the Netherlands. The article was published in “Clinical Biomechanics,” 1995; 10,5:240-244.

Abásolo L, Blanco M, Bachiller J, Candelas G, Collado P, Lajas C, Revenga M, Ricci P, Lázaro P, Aguilar MD, Vargas E, Fernández-Gutiérrez B, Hernández-García C, Carmona L, Jover JA. A Health System Program To Reduce Work Disability Related to Musculoskeletal Disorders. Annals of Internal Medicine 2005 143( 6):404-414

Abspoel M, Bernards ATM, Oostendorp RAB. [Physical therapy in sympathetic reflex dystrophy]. Amersfoort, The Netherlands: Stichting Wetenschap en Scholing Fysiotherapie; 1994:39

Abumi K, Panjabi M, Kramer K, Duranceau J, Oxland T, Crisco J. Biomechanical Evaluation of Lumbar Spinal Stability after Graded Facetectomies. Abumi et al. 1990; 1142-1147

Adson AW, Coffey JR. Cervical rib: a method of anterior approach for relief of symptoms by division of the scalenus anticus. Ann Surg. 1927; 85:839-855.

Adson AW. Cervical ribs: symptoms differential diagnosis and indications for section of the insertion of the scalenus anticus muscle. J Int Coll Surg. 1951; 15:546-559.

Ambrad-Chalela E, Thomas GI, Johansen KH. Recurrent neurogenic thoracic outlet syndrome. Am J Surg. 2004; 187(4):505-510.

An HS, Vaccaro A, Cotler JM, Lin S. Spinal disorders at the cervicothoracic junction. Spine 1994; 22:2557-564

Andriacchi T, Schultz A, Belytschko T, Galante J. A Model for Studies of Mechanical Interactions Between the Human Spine and Rib Cage. J. Biomechanics. 1974;7:497-507

Annals of Vascular Surgery. 18(5):558-65, 2004 Sep.

Atasoy E: Thoraic outlet compression syndrome. Orthop Clin North Am. 1996;27:265-303.

Aubin CE, Dansereau J, de Guise J, Labelle H. Rib Cage-Spine Coupling Patters Involved in Brace Treatment of Adolescent Idiopathic Scoliosis. Spine. 1997;22:629-635

Bacillin SD. Meningovertebral ligaments and their putative significance in low back pain. J Manipulative Physiol Ther. 1996;19:592-596

Bailey AS, et al. Anatomic relationships of the cervicothoracic junction. Spine. 1995; 20,13:1431-1439.

Bashline S, Bilott J, Ellis JP. Meningovertebral Ligaments and Their Putative Significance in Low Back Pain. Journal of Manipulative and Physiological Therapeutics. 1996;19;9:592-596

Bergsmann O, Eder M. [Functional pathology and clinical aspects of the thoracic spine]. In: Gutmann G. [Functional pathology and clinical aspects of the spine]. Stuttgart, Germany: Gustav Fischer; 1982

Bhalla SK . Cervical spine: recent observations on anatomy and clinical application. J Can Phys Assoc. 1968;20:2-8

Boszczyk et al. An immunohistochemical study of the dorsal capsule of the lumbar and thoracic facet joint. Spine. 2001; 26,15:338-343.

Boyle JJ, Singer KP, Milne N. Morphological survey of the cervicothoracic junctional region. Spine. 1996;21:544-548

Boyle JJW et al. Morphological sdurvey of the cervicothoracic junctional region. Spine 1996; 21:544-48

Brain WR, Lord JW, Wilkinson M, eds. Cervical spondylosis. London: Heinemann; 1967

Brantigan CO, Roos DB. Diagnosing thoracic outlet syndrome. Hand Clinics. 2004; 20,1:27-36.

Brismée J, Gilbert K, Sizer P, Sawyer S, Isom K, Hall R, Leathers B, Sheppard N. The Rate of False Positive Using the Cyriax Release Test for Thoracic Outlet Syndrome in n Asymptomatic Population. Journal of Manual and Manipulative Therapy. 2004, in press.

Broc G, Crawford N, Sonntag V, Dickman C. Biomechanical Effects of Transthoracic Microdiscectomy. Spine. 1997;22:6:605-612

Chen D-J et al. Unusual thoracic outlet syndrome secondary to fractured clavicle. J Trauma Inj Inf Crit Care 2002; 52:393-8

Clagett OT. Presidential Address: research and prosearch. J Thorac Cardiovasc Surg. 1962;16:354-358

JA Cleland, JM Whitman, JM Fritz, JA Palmer. Manual physical therapy, cervical traction, and strengthening exercises in patients with cervical radiculopathy: A case series. JOSPT 2005;35:802-811

Conroy JL, Schneiders AG. The T4 syndrome. Manual Therapy. 2005;10:292-296

Coppeiters MW et al. Addition of test components during neurodynamic testing: Effect on range of motion and sensory responses. JOSPT 2001; 31:226-37.

Crawford. Thoracic outlet syndrome. Surg Clin North Am. 1980; 60:947-956.

d.Kerr AT. The brachial plexus of nerves in man, the variations in its formation and its branches. Am J Anat. 1918;23:285-395

Dahlin LB. Rydevik B. Pathophysiology of nerve compression. In: Gelberman RH. Operative Nerve Repair and Reconstruction. Philadelphia: J.B. Lippincott Company; 1991:847-866.

DeFranca GG, Levine LJ. The T4 Syndrome. Journal of Manipulative and Physiological Therapeutics. 1995; 18,1:34-37

Degeorges R. Reynaud C. Becquemin JP. Department of Vascular Surgery, Henri Mondor Hospital, Creteil, France. renaud.degeorges@libertysurf.fr. Thoracic outlet syndrome surgery: long-term functional results.

Delamarter RB et al. The C7-T1 junction: Problems with diagnosis, visualization, instability and decompression. Orthop Trans. 1989: 13:218

Delamarter RB, Batzdorf U, Bohlman HH. The C7-T1 junction: problems with diagnosis, visualization, instability and decompression. Orthop Trans . 1989;13:218

Devor M. 2001. Neuropathic pain. Presented at the 2nd World Congress of the World Institute of Pain. June 26-29, Istanbul, Turkey.

Dreyfuss P, Tibiletti C, Dreyer S. Thoracic Zygapophyseal Joint Pain Patterns. Spine. 1994:19;7:807-811

Dreyfuss P. Thoracic zygapophyseal joint pain patterns. Spine. 1994;19:807-811

Dwyer A, Aprill C, Bogduk N, Cervical zygapophyseal joint pain patterns I: A study in normal volunteers. Spine. 1990; 15:453-461.

Dwyer AF, Newton NC, Sherwood AA. An Anterior Approach to Scoliosis. Clinical Orthopaedics and Related Research. 1969;62:192-202

Ebraheim NA, Jabaly G, Xu R, Yeasting RA. Anatomic relations of the thoracic pedicle to the adjacent neural structures. Spine. 1997;22:1553-1557.

Ebraheim NA, Jabaly G, Xu RA, Yeasting RA. Anatomic Relations of the Thoracic Pedicle to the Adjacent Neural Structures. Spine. 1997;22;14:1553-1557

Ebraheim NA, Xu R, Ahmad M, Yeasting RA. Projection of the Thoracic Pedicle and Its Morphometric Analysis. Spine. 1997;22;3:233-238

Ebraheim NA, Xu R, Ahmad M, Yeasting RA. The Quantitative Anatomy of the Thoracic Facet and the Posterior Projection of Its Inferior Facet. Spine. 1997;22;16:1811-1818

Ebraheim NA. Anatomic relations of the thoracic pedicle to the adjacent neural structures. Spine 1997; 22:1553-57

Estilaei SK, Byl NN. An evidence-based review of magnetic resonance angiography for diagnosing arterial thoracic outlet syndrome. J Hand Ther 2006;19:410-419

Evans DK. Dislocation at the cervicothoracic junction. J Bone Surg 1991: 65B: 124-7

Failé T. Het T4-syndroom. Nederlands Tijdschrift voor Manuele Therapie. 1988. 7,2: 38-40

Fielding JW, Burstein AA, Frankel VH. The nuchal ligament. Spine. 1976;1:3

Firsoy GI. Cervical ribs and their distincion from underdeveloped first rib. Arch Anat Hist Embryol. 1974; 67:101-103.

Fisher AM, Gorelick PB. Entrapment Neuropathies: differential diagnosis and management. Postgrad Med. 1985;77:160-17

Fisher AM, Gorelick PB. Entrapment Neuropathies: differential diagnosis and management. Postgrad Med. 1985;77:160-174

Fisher MA, Gorelick PB. Entrapment neuropathies: differential diagnosis and management. Postgrad Med. 1985;77(1):160-174

Floman Y. Thoracic scoliosis and restricted neck motion: a new syndrome? A report of six cases. Eur Spine J. 1998;7:155-157.

Foreman RD. Mechanisms of Cardiac Pain. Annu. Rev. Physiol. 1999;61:143-167.

Fraser DM. T-3 revisited. J Orthop Med. 1993;15:3-4. McGuckin N. The T4 syndrome. In: Grieve GP, ed. Modern Manual Therapy of the Vertebral Column. Edinburgh: Churchill Livingstone; 1986.

Fraser DM. T-3 Revisited. Journal of Orthopaedic Medicine. 1993. 15,1: 3-4

Fujimura Y, Nishi Y, Nakamura M, Toyama Y, Suzuki N. Long-Term Follow-Up Study of Anterior Decompression and Fusion for Thoracic Myelopathy Resulting from Ossification of the Posterior Longitudinal Ligament. Spine. 1997;22;3:305-311

Fujita K et al. Late thoracic outlet syndrome secondary to malunion of the fractured clavicle: Case report and review of literature. J Trauma Inj Inf Crit Care 2001; 50:332-5

Fung M, et al. Scapular and clavicular kinematics during humoral elevation: A study with cadavers. J Sh Elb Surg 2001; 10:278-285

Geelhoed MA, McGaugh J, Brewer PA, Murphy D. A New model to facilitate palpation of the level of the transverse process of the thoracic spine. JOSPT 2006;36(11):876-881

Gelberman and coworkers (THE CARPAL TUNNEL SYNDROME; A STUDY OF CARPAL CANAL PRESSURES. J BONE JOINT SURG. 1981;63A:380-383

Gisel A, Wicke L, Schmiedl R. [Functional anatomy and radiographic antomy of the spine.] In Gutman G, ed. Functional Pathology and Clinical Aspects of the Spine. Stuttgar: Gustav Fischer;1987

Goodear M, Styles C. Stress Fractures of the Thoracic Spine Transverse Processes in a Water Skier. Clinical Nuclear Medicine. 1999;24;4:285-286

Gregersen G, Lucas DB. An in vivo study of axial rotation of the human thoraco-lumbar spine motion segments. J Bone Joint Surg. 1967;59A:247-262

Gregersen GG, Lucas DB. An In Vivo Study of the Axial Rotation of the Human Thoracolumbar Spine. Journal of Bone and Joint Surgery. 1967;49-A;2:247-262

Grieve GP. The movements of the thoracic spine. In: Grieve GP, ed. Modern Manual Therapy of the Vertebral Column. Edinburgh: Churchill Livingstone; 1986

Grigoriev PS, Ivannikov VP, Sokov LP, Savelieva SI. [Treatment of pain in patients with ischemic heart disease and osteochondrosis of the cervicothoracic vertebrae]. Kardiologiia. 1983;23:72-76

Grigorieve PS, Ivannikov VP, Sokov LP, Savelieva SI. [Treatment of pain in patients with ischemic heart disease and osteochondrosis of the cervicothoracic vertebrae]. Kardiologiia. 1983; 23:72-76

Guilbaud G, Bernard J-F, Besson J-M. Brain areas involved in nociception and pain. In Wall PD, Melzack R (Eds) Textbook of Pain (CD-ROM), 1997. Record 1727.

Hanno Millesi et al. MECHANICAL PROPERTIES OF PERIPHERAL NERVES. CLINICAL ORTHOPAEDICS AND RELATED RESEARCH. 1995; 314:76-83

Heller JG, Pedlow FX Jr. Anatomy of the cervical spine. In: Clark CR, ed. The cervical spine. Philadelphia; Lippincott – Raven; 1998: 7.

Hewitt W. The intervertebral foramen. Physio. 1970;56:332.

Ireland AJ, Britton I, Forrester AW. Do supine oblique views provide better imaging of the cervicothoracic junction than swimmer’s views? J Accid Emerg Med. 1998;15:151-154.

Jamieson WG, Chinnick B. Thoracic outlet syndrome: fact or fancy? A review of 409 consecutive patients who underwent operation. Canadina J Surg. 1996;39:321-326

Jiang H, Raso JV, Moreau MJ, Russell G, Hill DL, Bagnall KM. Quantitative Morphology of the Lateral Ligaments of the Spine. Spine. 1994;19;23:2676-2682

Jirout [the effect of unilateral dominance of the cerebral hemispheres on the radiographic appearance of the cervical spine] Radiologe 1980; 20:466-9

Jirout J. [The effect of unilateral dominance of the cerebral hemispheres on the radiographic appearance of the cervical spine]. Radiologe. 1980 ;20:466-469

Jirout J. [The joint play]. In: [The cervical spine. Part 3]. In: Gutmann G. [Functional pathology and clinical aspects of the spine]. Stuttgart, Germany: Gustav Fischer; 1990:59 – 60

Jirout J. [The joint play]. In: [The cervical spine. Part 3]. In: Gutmann G. [Functional pathology and clinical aspects of the spine]. Stuttgart, Germany: Gustav Fischer; 1990:52 – 59

Johnson et al. The fine connective tissue architecture of the human ligamentum nuchea. Spine. 2000; 25:5-9

Juvonen T, Satta J, Laitala P, Luukkonen K, Nissinen J. Anomalies at the thoracic outlet are frequent in the general population [see comments]. Am J Surg. 1995;170:33-37

Kataoka Y. [Pathogenesis of thoracic outlet syndrome: diagnosis with neurography of the brachial plexus]. J Jap Orthop Assoc. 1994;68:357-36

Kataoka Y. [Pathogenesis of thoracic outlet syndrome: diagnosis with neurography of the brachial plexus]. J Jap Orthop Assoc. 1994;68:357-366

Kataoka Y.[Pathogenesis of thoracic outlet syndrome: diagnosis with neurography of the brachial plexus]. Nippon Seikeigeka Gakkai Zasshi. 1994;68:357-366.

Kerr AT. The brachial plexus of nerves in man, the variations in its formation and its branches. Am J Anat. 1918;23:285-395

Koknel Talu G. Thoracic outlet syndrome. Agri. 2005 Apr;17(2):5-9.

N Korkmaz, L Ozcakar. Long cervical costae articulating with the first ribs: A salient case of thoracic outlet syndrome. Am J Phys Med Rehab, 2006;85: 104.

Kumazawa T. Primitivism and plasticity of pain-Implication of polymodal receptors. Neurosci Res 1998; 32: 9-31.

Kwan MK, Woo S L-Y. Biomechanical properties of peripheral nerve. In: Gelberman RH. Operative nerve repair and reconstruction. Philadelphia: J.B. Lippincott Company; 1991:47-54

Lee D. Biomechanics of the Thorax: A Clinical Model of in Vivo Function. The Journal of Manual and Manipulative Therapy. 1993;1;1:13-21

Leffert RD. Thoracic outlet syndrome. In Gelberman RH. Operative nerve repair and reconstruction. Philadelphia: JB Lippincot Company 1991; 1:1177.

Lefffert RD. Thoracic Outlet Syndrome. In: Gelberman RH, ed. Operative Nerve Repair and Reconstruction. New York: Lippincott;1991:1183-1185

Leishout, Greive, & Bowden . In Brain WR, Lord JW, Wilkinson M eds. Cervical Spondylosis. London: Heinemann; 1967

Leong et al. Kinematics of the chest cage and spine during breathing in healthy individuals and in patients with adolescent idiopathic scoliosis. Spine. 1999; 24,13:1310

Leonhardt H, Tillmann B, et al, eds. Anatomie des Menschen. Stuttgart: Georg Thieme Verlag; 1987: 177

Lindgren KA et al. Cervical rotation lateral flexion test in brachalgia. Arch Phys Med Rehabil 1992; 73:735-737.

Lindgren KA et al. Cervical spine rotation and lateral flexion combined motion in the examination of the thoracic outlet. Arch Phys Med Rehabil 1990; 71:343-345.

Lindgren KA. Conservative treatment of thoracic outlet syndrome: a 2-year follow-up. Arch Phys Med Rehabil. 1997; 78:373-378.

Lindgren KA., Cervical spine rotation and lateral flexion combined motion in the examination of the thoracic outlet. Archives of Physical Medicine and Rehabilitation. 71:343-4, 1990.

Liu CT, Benda CE, Lewey FH. Tensile strength of human nerves. Arch Neurol. 1948;59:322

Loebl WY. Measurement of Spinal Posture and Range of Spinal Movement. Annals of Physical Medicine. 1967;IX;3:103-110

Lucas ML, Berg EE. Unilateral Thoracic Facet Dislocation. Clinical Orthopaedics and Related Research. 1997;335:162-165

Lundborg G, Rydevik B. Effects of stretching the tibial nerve of the rabbit: a preliminary study of the intraneural circulation and the barrier function of the perinerium. J Bone Joint Surg. 1973;55B:390-401

Lundborg G. Ischemic nerve injury: experimental studies on Intraneural microvascular pathophysiology and nerve function in a limb, subjected to temporary circulatory arrest. Scan J Plast Reconstr Surg. 1970;6S:1-113

Lysell E. Motion in the cervical spine. An experimental study on autopsy specimens. Acta Orthop Scand Suppl. 1969:123

Maat G, Matricali B, van Persijn van Meerten E. Postnatal Development and Structure of the Neurocentral Junction. Its Relevance for Spinal Surgery. Spine. 1996;21;6;661-666

Machleder HI, Moll F, Verity A. the anterior scalene muscles abnormalities in traumatic thoracic outlet syndrome: histochemical and morphometric studies. Arch Surg. 1986; 121:1141-1144.

Maigne R, LeCorre F. New ideas on the mechanism of common adult dorsalgia. Man Med. 1969;4:73

Maitland GD. Vertebral Manipulation. 4th edition. Butterworth: London. 1997

Mannion AF, Dumas GA, Cooper RG, Espinosa FJ, Faris MW, Stevenson JM. Muscle Fibre Size and Type Distribution in Thoracic and Lumbar Regions of Erector Spinae in Healthy Subjects without Low Back Pain: Normal Values and Sex Differences. J. Anat. 1997;190:505-513

Masataka A, Katsuaki I, Nishida. Diagnosis, treatment, and complications of thoracic outlet syndrome. J Orthop Sci. 1999; 4:66-69.

Matsumoto AN EXPERIMENTAL STUDY ON COMPRESSION NEUROPATHY: MEASUREMENT OF BLOODFLOW WITH THE HYDROGEN WASH-OUT TECHNIQUE. J JAP ORTHOP ASSOC. 1983;57:805-816

Matsumura JS, Rilling WS, Pearce WH, Nemcek AA Jr, Vogelzang RL, Yao JS. Helical computed tomography of the normal thoracic outlet. J Vasc Surg. 1997;26:776-783

McClure PW, Michener LA, Sennet BJ, Karduna AR. Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo. J Sh Elb Surg 2001; 10:269-277.

McGuckin N. The T4 Syndrome. In: Modern Manual Therapy. Eds. Grieve

McLain RF, Pickar JG. Mechanoreceptor Endings in Human Thoracic and Lumbar Facet Joints. Spine. 1998;23,2:168-173

McLain, Pickar. Mechanoreceptor endings in human thoracic and lumbar facet joints. Spine. 1998; 32,2:168-173

Mellick GA, Mellick LB. Clinical presentation, quantitative sensory testing, and therapy of 2 patients with fourth thoracic syndrome. J Manipulative Physiol Ther. 2006;29(5):403-8.

Menck JY. Requejo SM. Kulig K. Thoracic spine dysfunction in upper extremity complex regional pain syndrome type I. JOSPT. 2000; 30(7):401-409.

Meyer RA, Campbell JN, & Raja SN. Peripheral neural mechanisms of nociception. In Wall PD, Melzack R (Eds) Textbook of Pain (CD-ROM), 1997. Record 260

Miyamoto et al. EXPERIMENTAL STUDIES ON THE EFFECTS OF TENSION ON INTRANEURAL MICROCIRCULATION IN SUTURED PERIPHERAL NERVES. PLAST RECONSTR SURG 1979;63:398-403

Mummenthaler M. The shoulder arm syndrome, 2nd ed (German). Bern:Switzerland: Verlag Hans Huber, 1982:13

Mummenthaler M. The shoulder arm syndrome, 2nd ed. Bern: Switzerland: Verlag Hans Huber; 1982: 63

Nakamichi. RESTRICTED MOTION OF THE MEDIAN NERVE IN CTS. J HAND SURG 1995; 20B:460-464

Nathan H, Feuerstein M. Angulated course of spinal nerve roots. J Neurosurg. 1974;32:349

Nathan H, Schwartz A. Inverted Pattern of Development of Thoracic Vertebral Osteophytosis in Situs Inversus and in other Instances of Right Descending Aorta. Radiol. clin. 1962;31:150-158

Natsis K, et al. Variations of the course of the upper trunk of the brachial plexus and their clinical significance for the thoracic outlet syndrome: a study on 93 cadavers. Am Surg. 2006;72(2):188-92.
Nguyen T 4th, Baumgartner F, Nelems B. Bilateral rudimentary first ribs as a cause of thoracic outlet syndrome. J Natl Med Assoc. 1997;89:69-73

Nichos et al. Evaluation of cervicothoracic junction injury. Ann Emerg Med 1987: 16:640-51

Norlander S, B Nordgren. Clinical Symptoms Related to Musculoskeletal Neck-Shoulder Pain and Mobility in the Cervicothoracic Spine Scandinavian Journal of Rehabilitation Medicine. 1998;30:243-251

Norlander S, BA Gustavsson, J Lindell, B Nordgren. Reduced Mobility in the Cervicothoracic Motion Segment – A Risk Factor for Musculoskeletal Neck-Shoulder Pain – A 2-Year Prospective Follow-Up-Study. Scandinavian Journal of Rehabilitation Medicine. 1997;29:167-174.

Norlander S, U Astenorlander, B Nordgren, B Sahlstedt. Mobility in the Cervicothoracic Motion Segment – An Indicative Factor of Musculoskeletal Neck-Shoulder Pain. Scandinavian Journal of Rehabilitation Medicine. 1996;28:183-192.

Novak CB et al. Outcome following conservative management of thoracic outlet syndrome. J Hand Surg. 1995;20A:542-8.

Oda I, Abumi K, Lu D, Shono Y, Kaneda K. Biomechanical role of the Posterior Elements, Costovertebral Joints, and Rib Cage in the Stability of the Thoracic Spine. Spine. 1996;21;12:1423-1429

Okereke CD et al. Arterial Thoracic ourlet compression syndrome: A differential diagnosis of painful right supraclavicular swelling? Hosp Med 2000; 61:672-3

Onan OA, Heggeness MH, Hipp JA. A motion analysis of the cervical facet joint. Spine. 1998;23:430-439

Oostendorp R. [Functional vertebrobasilar insufficiency]. Thesis. University of Nijmegen, The Netherlands; 1988

Ordway NR, Seymour RJ, Donelson RG, Hojnowski LS, Edwards WT. Cervical flexion, extension, protrusion, and retraction. A radiographic segmental analysis. Spine.1999; 24:240-247

Panjabe et al. Three dimensional load displacement curves due to forces on the cervical spine. J Orthop Res. 1986; 4:152

Panjabi M, Duranceau J, Goel V, Oxland T, Takata K. Cervical human vertebrae. Quantitive three-dimensional anatomy of the middle and lower regions. Spine. 1993;16:861-874

Panjabi MM, Brand Jr, RA, White III AA. Mechanical Properties of the Human Thoracic Spine. The Journal of Bone and Joint Surgery. 1976;58-A;5;642-652

Panjabi MM, Brand RA Jr., White AA III. Three-Dimensional Flexibility and Stiffness Properties of the Human Thoracic Spine. J. Biomechanics. 1976;9:185-192

Panjabi MM, Hausfeld JN, White III AA. A Biomechanical Study of the Ligamentous Stability of the Thoracic Spine in Man. Aeta orthop. Scand. 1981;52:315-326

Panjabi MM, Summers DJ, Pelker RR, Videman T, Friedlaender GE, Southwick WO. Three dimensional load displacement curves due to forces on the cervical spine. J Orthop Res. 1986;4:152

Panjabi MM, White AA III. Clinical biomechanics of the spine, 2nd ed. Philadelphia: J.B. Lippincott Company; 1990:103

Pather N, Partab P, Singh B, Satyapal KS. Cervico-thoracic ganglion: Its clinical implications. Clin Anat. 2005 Nov 29;

Penning L. Functional pathology of the cervical spine. Amsterdam, The Netherlands: Excerpta Medica Foundation;1968:18

Pic RY, Segal D. C7-T1 Bilateral facet dislocation; A rare lesion presenting with the syndrome of acute anterior spinal cord injury. Clin Orthop Rel Res. 1980: 150:131-6

Pick RY, Segal D. C7—T1 bilateral facet dislocation: a rare lesion presenting with the syndrome of acute anterior spinal cord injury. Clin Orthop. 1980;150:131-136.

Plewa MC, Delinger M. the false-positive rate of thoracic outlet syndrom shoulder maneuvers in healthy subjects. Acad Emerg Med. 1998; 5:337-342.

Plewa MC, Delinger M. the false-positive rate of thoracic outlet syndrome shoulder maneuvers in healthy subjects. Acad Emerg Med. 1998; 5:337-342.

Pollak E. Surgical anatomy of the thoracic outlet syndrome. Surg Gynecol Obstet. 1980; 150:97-103.

Post NH, Cooper PR Unique features of herniated discs at the cervicothoracic junction: clinical presentation, imaging, operative management, and outcome after anterior decompressive operation in 10 patients. Neurosurgery. 2006;58:497-501

Rayan GM. Thoracic outlet syndrome. J Shoulder Elbow Surg. 1998;7:440-451

Reichert FL. Compression of brachial plexus: The scalus anticus syndrome. JAMA 1942; 114:294-6.

Resnick DK, Weller SJ, Benzel EC. Biomechanics of the Thoracolumbar Spine. Management of the Thoracolumbar Stability. 1997;8;4:455-469

Rob CG, Standeven A. Arterial occlusion complicating thoracic outlet compression syndrome. Br Med J. 1958;2:709-712

Robinson AJ: Central nervous system pathways for pain transmission and pain control: Issues relevant to the practicing clinician. J. Hand Ther. 1997; 10: 64-77.

Rogers MA Crockard HA. Surgical treatment of the symptomatic herniated thoracic disc. Clin Orthop 1994; 300:70-78

Roos BD. The thoracic outlet syndrome is underrated. Arch Neur. 1990;47:327-328

Roos DB. Historical perspectives ad anatomic consideratins. Seminars in thoracic and cardiovascular surgery. 1998; 8,2:183-189.

Roos DB. Historical perspectives and anatomic considerations. Sem Thoracic and Cardiovasc Surg. 1996;8:183-189

Roos DB. Historical perspectives and anatomic considerations. Seminars in Thoracic and Cardiovascular Surgery. 1996; 8,2:183-189.

Rusnak-Smith S et al., Anatomical variations of the scalene triangle: Dissection of 10 cadavers. J Orthop Sports Phys ther. 2001;31:70-80.

Sanders RJ, Pearce WH. The treatment of thoracic outlet syndrome: a comparison of different operations. Vasc Surg. 1989; 10:626-634.

Sanders RJ., Scalene muscle abnormalities in traumatic thoracic outlet syndrome. Am J of Surg. 1990;159:231-236

Sanders RJ, Hammond SL, Rao NM. Diagnosis of thoracic outlet syndrome. J Vasc Surg 2007;46:601-604

Schellhas KP, Pollei SR, Dorwart RH. Thoracic Discography-A Safe and Reliable Technique. Spine. 1994;19;18:2103-2109

Schnyder H, Rosler KM, Hess CW. [The diagnostic significance of additional electrophysiological studies in suspected neurogenic thoracic outlet syndrome]. Schweiz Med Wochenschr.1994;124:349-356

Schultz AB, Belytschko TB, Andriacchi TP. Analog Studies of Forces in the Human Spine: Mechanical Properties and Motion Segment Behavior. J. Biomechanics. 1973;6:373-383

Schultz AB, Benson D, Hirsch C. Force deformation properties of human ribs. J. Biomech. 1974;7:303

Schultz AB, Hirsch C. Mechanical Analysis of Techniques for Improved Correction of Idiopathic Scoliosis. Clinical Orthopaedics and Related Research. 1974;100:66-73

Seradge H, Owen W. Cubital tunnel release with medial epicondylectomy factors influencing the outcome. J Hand Surg [Am] 1998 May;23(3):483-91

Seror P. Frequency of neurogenic thoracic outlet syndrome in patients with definite carpal tunnel syndrome: an electrophysiological evaluation in 100 women. Clin Neurophysiol. 2005; 116(2):259-263.

Shacklock MO. Moving in on Pain. Australia: Butterworth-Heineman; 1995.

Shellhas KP, Smith MD, Gundry CR, Pollei SR. Cervical discogenic pain. Prospective correlation of magnetic resonance imaging and discography in asymptomatic subjects and pain sufferers. Spine. 1996;21:300-312

Shenoi RM, Duong TT, Brega KE, Gaido LB. Ossification of the Ligamentum Flavum Causing Thoracic Myelopathy-A case report. American Journal of Physical Medicine and Rehabilitation. 1997;76;1:68-72

Sherk HH, Dawoud S. congenital os odontoideum with Kilppel-Feil anomaly and fatal atlanto[axial instability: report of a case. Spine. 1981;6:42

Sheth, Belzberg. Diagnosis and treatment of thoracic outlet syndrome. Neurosurgery Clinics of North America. 2001; 12,2:295-309.

Shore LR. On osteo-arthritis in the dorsal intervertebral joints: A study in morbid anatomy. Br J Surg. 1985: 22:833-49

Sizer P, Brismée J, Gilbert K, Sawyer S, Call D, Branscum S, Finger E, Maness J, Redman N. The Incidence of Positive Cervical Rotation-lateral Flexion Tests for Elevated First Ribs in Asymptomatic Subjects and Correlations with Cervical Range of Motion Measurements. Journal of Manual & Manipulative Therapy. 2002; 10(3):166-167

Sizer PS Jr, Brismée JM, Cook C. Coupling behavior of the thoracic spine: a systematic review of the literature. J Manipulative Physiol Ther. 2007 Jun;30(5):390-9

Smith TM, Brismée JM, Dedrick GS, Sawyer SF, Sizer PS. The Double Crush Syndrome: A Common Occurrence In Cyclists With Symptoms Of Ulnar Nerve Neuropathy. Journal of Manual & Manipulative Therapy. 14(3):182, 2006

Sobel JS, Winters JC, Groenier K, Arendzen JH, Meyboom de Jong B. Physical examination of the cervical spine and shoulder girdle in patients with shoulder complaints. J Manipulative Physiol Ther. 1997;20:257-262

Stanescu S et al. Morphometric evaluation of the cervico-thoracic junction. Spine 1994; 19:2082-8

Stanescu S, Ebraheim NA, Yeasting R, Bailey AS, Jackson WT. Morphometric evaluation of the cervico-thoracic junction. Spine. 1994;19:2082-2088

Stoddard A. Manual of osteopathic technique, 3rd ed. London: Hutchinson; 1981
Swift TR, Nichols FT. the droopy shoulder syndrome. Neurology. 1984; 34:212-215.

Stone RJ, Stone JA. Atlas of Skeletal Muscles. McGraw-Hill International. 2006.

Takeuchi T, et al. biomechanical role of the intervertebral disc and costovertebral joint in stability of the thoracic spine. 1999. Spine; 24,24:1414-1420.

Todd T. The descent of the shoulder after birth. Anatomischer Anzeiger Centrallblatt fur die gesamte wissenschaftliche Anatomie. 1912;14:358-397

Todd. The descent of the shoulder after birth: its significance in the production of the pressure-symptoms of the lowest brachial trunk. Anat Anz. 1912; 41:385-397.

TW Wright, F Glowczewskie, D Wheeler, G Miller, D Cowin. Excursion and Strain of the Median Nerve. J of Bone Joint Surg. 1996;78A:1897-1903.

Urschel, Razzuk. Improved management of the Paget-Schroetter syndrome secondary to thoracic outlet compression. Ann Thorac Surg. 1991; 52:1217-1221.

Urschel HC, Kourlis H. Thoracic outlet syndrome: a 50-year experience at Baylor University Medical Center. Proc (Bayl Univ Med Cent). 2007 Apr;20(2):125-35.

Valenti, P.; Chourif, S. Naser; Gilbert, A. THORACIC OUTLET SYNDROME AFTER FRACTURE OF THE CLAVICLE: EIGHT CASES. Journal of Bone & Joint Surgery – British Volume. 86-B Supplement I:64, 2004.

Vallsole. LIMITED LONGITUDINAL SLIDING OF THE MEDIAN NERVE IN PATIENTS WITH CTS. MUSCLE AND NERVE. 1995; 18:761-767

Van der El. [Wervelkolom. Manuele Diagnostiek]. Rotterdam: Manthel; 1992:453.

van der Helm FCT, Pronk GM. Three-Dimensional Recording and Description of Motions of the Shoulder Mechanism. J of Biomech Engineering. 1995;117:27

van der Helm FCT. Analysis of kinematic and dynamic behavior of the shoulder mechanism. J Biomech 1994; 27:527-550.

Van Oostenbrugge RJ, Herpers MJ, de Kruijk JR. Spinal cord Compression Caused by Unusual Location and Extension of Ossified Ligamenta Flava in a Caucasian Male. Spine. 1999;24;5:486-488

Vanichkachorn, Vaccaro. Thoracic disc disease: diagnosis and treatment. JAAOS. 2000. 8,3:159-169

Vanti C, Natalini L, Romeo A, Tosarelli D, Pillastrini P. Conservative treatment of thoracic outlet syndrome. A review of the literature. Eura Medicophys. 2007 Mar;43(1):55-70.

Wall EJ, Bylski-Austrow DI, Shelton FS, Crawford AH, Kolata RJ, Baum DS. Endoscopic Discectomy Increases Thoracic Spine Flexibility as Effectively as Open Discectomy. 1998;23;1:9-16

Wall EJ, Kwan MK, Garfin SR, Woo SL-Y. Stress relaxation of a peripheral nerve. Proc 36th Ann Mtg, Orth Res Soc. 1990;15:579

Wall P..Treatment of Pain.
In: Shacklock M, Ed. Moving in on Pain.1994

Wall P, Melzack R, eds. Textbook of Pain. 3rd Ed. New York: Churchill Livingstone; 1994.

Walsh MT. Therapist management of thoracic outlet syndrome. J Hand Ther 1994; 131-44.

Wehbe MA, Leinberry CF. Current trends in the treatment of thoracic outlet syndrome. Hand Clinics. 2004; 20(1):119-121.

Wehbe MA. Schlegel JM. Nerve gliding exercises for thoracic outlet syndrome.Hand Clinics. 2004; 20(1):51-55.

Weinberg H et al. Arthritis of the first costovertebral joint as a cause of thoracic outlet syndrome. Clin Orthop Rel Res 1972; 159-63.

White AA III, Panjabi MM. Clinical biomechanics of the spine, 2nd ed. Philadelphia; J.B. Lippincott; 1990:117

White AA III, Panjabi MM. Clinical biomechanics of the spine, 2nd ed. Philadelphia: J.B. Lippincott; 1990:312

White AA III, Panjabi MM. Clinical biomechanics of the spine, 2nd ed. Philadelphia: J.B. Lippincott; 1990: 86-125

White AA III, Panjabi MM. Clinical biomechanics of the spine, 2nd ed. Philadelphia: J.B. Lippincott; 1990:103

White AA III, Panjabi MM. Clinical biomechanics of the spine, 2nd ed. Philadelphia: J.B. Lippincott; 1990:44

White AA. Analysis of the mechanics of the thoracic spine in man [thesis]. Acta Orthop Scan. 1969:127S

White III AA, Hirsch C. The Significance of the Vertebral Posterior Elements in the Mechanics of the Thoracic Spine. Clinical Orthopaedics and Related Research. 1971;81:2-14

Wilbourn AJ. The thoracic outlet syndrome is overdiagnosed. Arch Neurol. 1990;47:328-330

Wilbourne, Porter: Thoracic outlet syndrome. In Weiner: Spine: State of the Art Reviews. Philadelphia, Hanley and Belfus, 1988, pp 598-626.

Williams AF. The role of the first rib in the scalenus anterior syndrome. J Bone Joint Surg. 1952;34B:200-203.

Williams DA, Keefe FJ. Pain beliefs and the use of cognitive-behavioral coping strategies. Pain 1991; 46:185-190

Williams PL, Warwick R, Dyson M, Bannister LH, eds. Gray’s Anatomy. Edinburgh: Churchill Livingstone; 1989

Willis W D, Coggeshall R E. 1991. Sensory mechanisms of the spinal cord, 2nd edn. Plenum Press, New York.

Wolff CF, Thompson JW. Stimulation-induced analgesia: transcutaneous electric nerve stimulation and vibration. In Wall P, Melzak R, eds. Texbook of Pain

Wolock B, Millesi H. Brachial plexus – Applied anatomy and operative exposure. In: Gelberman RH, ed. Operative nerve repair and reconstruction. Philadelphia: J.B. Lippincott;1991

Wood KB, Blair JM, Aepple DM, Schendel MJ, Garvey TA, Gundry CR, Heithoff KB. The Natural History of Asymptomatic Thoracic Disc Herniations. Spine. 1997;22;5:525-530

Wood KB, Garvey TA, Gundry C Heithoff KB. Magnetic resonance imaging of the thoracic spine; Evaluation of asymptomatic individuals. J Bone Joint Surg (Am) 1995; 77: 1631-1638

Wood KB, Garvey TA, Gundry C, Heithoff KB. Magnetic Resonance Imaging of the Thoracic Spine. The Journal of Bone and Joint Surgery. 1995;77-A;11:1631-1638

Wood V, Biondi J. Double crush nerve compression in thoracic outlet syndrome. J Bone Joint Surg Am. 1990; 72A:85-87.

Wood VE. Thoracic outlet syndrome: the result of first rib resection on 100 patients. Orthop Clin North America. 1988;19:131-145

Yeow K-M & Hsieh H-C. Thoracic outlet syndrome caused by first rib hemangioma. J Vasc Surg 2000; 33:1118-21.

Yeow K-M & Hsieh H-Cjain S et al. Thoracic outlet syndrome caused by chronic retrosternal dislocation of the clavicle. Successful treatment by transaxillary resection of the first rib. J Bone Joint Surg 2002; 84B:116-8:1118

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