Thoracic Outlet Syndrome
Thoracic outlet syndrome (TOS) develops when the nerves or blood vessels traveling from the neck, beneath the collarbone, and into the arm become compressed. Neurogenic thoracic outlet syndrome — NTOS — accounts for over 90% of cases and produces numbness and tingling down the arm, worsening pain with overhead activity, radiating pain into the neck and shoulder blade, and weakness in the shoulder and hand. Because these symptoms overlap with carpal tunnel syndrome, cervical disc disease, and rotator cuff problems, many patients spend years without a clear answer.
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Dr. Ahmed is an international expert in NTOS and one of the few surgeons in the United States who performs all-endoscopic thoracic outlet decompression, pectoralis minor release, subclavius release, and brachial plexus neurolysis. This minimally invasive approach allows direct visualization of the brachial plexus through small incisions, without the extensive exposure and rib resection required in traditional open surgery.
He is one of the most published surgeons worldwide on this endoscopic NTOS technique, and teaches it to other surgeons at national and international meetings. Patients travel to Houston to see Dr. Ahmed from across the United States and from abroad for this specialized care.
Facts About Neurogenic Thoracic Outlet Syndrome
Symptoms of NTOS often worsen when the arms are elevated
TOS can affect nerves, veins, or arteries. Over 90% of TOS is NTOS (neurogenic)
Proper diagnosis often requires specialized testing
Understanding Neurogenic Thoracic Outlet Syndrome
The thoracic outlet is the narrow passageway from the neck, behind the collarbone, along the first rib, and into the arm through which important nerves, arteries, and veins travel. Compression within this space can produce a variety of symptoms depending on which structures are affected. Neurogenic thoracic outlet syndrome (NTOS) is the most common form, while venous and arterial thoracic outlet syndromes are less common.
Patients may experience pain in the neck, shoulder, arm, or hand, along with numbness, tingling, weakness, swelling, discoloration, or fatigue during overhead activities. Because these symptoms overlap with many other conditions, specialized evaluation is critical.
Treatment varies depending on the specific type of thoracic outlet syndrome, the chronicity (for how long the patient has had symptoms), and history of prior attempts at treatment.
Frequently asked questions
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