Affiliation:
1. Department of Physical Medicine and Rehabilitation University of Utah Salt Lake City Utah USA
2. Department of Neurosurgery University of Utah School of Medicine Salt Lake City Utah USA
3. Department of Orthopaedics University of Utah Salt Lake City Utah USA
Abstract
AbstractBotulinum toxin (BTX) injections into the musculature surrounding the brachial plexus have been examined as a potential treatment for neurogenic thoracic outlet syndrome (nTOS). This systematic review identified 15 publications, of which one was a randomized controlled trial. BTX injections performed with ultrasound or electromyographic guidance, and with the inclusion of the pectoralis minor muscle, in addition to the anterior and/or middle scalenes, tended to provide greater symptom improvement and may predict response to first rib resection. Importantly, most studies were of low quality; thus, the results should be interpreted with caution. Further high‐quality studies are needed to confirm these findings.