Long Thoracic Neuropathy When Initial Thoracic Decompression Fails to Resolve Scapular Winging
This protocol applies to patients with long thoracic neuropathy who have already undergone an initial surgical decompression procedure and have not achieved the expected improvement in scapular winging.
The first-line intervention was thoracic long thoracic nerve neurolysis (decompression of the thoracic LTN), performed as the initial surgical procedure. This protocol is indicated when that procedure did not produce complete or near-complete resolution of scapular winging, or failed to achieve meaningful improvement in the Wrightington Winging Score.
When the initial thoracic procedure is insufficient, a further surgical intervention may be considered as a second-stage approach. The complete technique, indications, and decision framework are available in the full protocol.
References
DOI: 10.1016/j.jhsg.2022.11.006
Our results of supraclavicular LTN decompression have been mixed and less predictable, as this was only offered to those patients who failed to achieve an improved outcome following thoracic decompression as a second-stage procedure.
View source ↗