Is Thoracic Outlet Syndrome Rare? What the medical literature tells us...

Join Dr. Scott Werden as he takes participants on a tour of the recent literature regarding Thoracic Outlet Syndrome and what these publications tell us regarding the prevalence of this challenging disease. Includes participant Q & A.

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Hello I'm Dr Scott Worden the TOs guy Welcome to our next installment of the TOs guy live stream today we're going to address a topic brought up to me by our operations manager herb rep he said is TOS rare what do we really know about it and I thought what a great idea for a talk I'm going to remind you as always to subscribe if you haven't subscribed yet keep an eye on us on social media we are TOS MRI on YouTube uh LinkedIn Twitter Instagram keep an eye open for us and please hit the like button for the video that helps us spread the word about TOs So today we're going to talk about TOS is TOS rare let's start with the slides what is the incidence of TOS how many people show up every year with TOs well let's take a look I went through the medical literature and I tried to track down exactly how people had figured out how common TOS is throughout the country mostly but there are a few other countries thrown in in the medical literature so starting with Lee in a book that I contributed to in 2013 Jason Lee wrote down that the incidence of TOS is between 3 and 80 patients per 1000 population that would be a lot that would be three thousand to eighty thousand per million population which actually seems rather High well he had gotten this information from a paper written by Huang in 2004. what did Huang say in 2004 well he said the 3 to 80 per 1000 population and he had gotten that from two references David Roos and ASA Wilborn in 1990. so I hadn't gotten to the bottom of it yet I pulled up those papers and read through those so in 1990 ruse wrote a paper with no mention at all of the incidents no numbers and I found Wilborn in 1990. he didn't have an estimate of incidents either although he did as we'll look at later come up with a concept of true neurogenic TOS versus disputed neurogenic TOS something I have great interest in for a number of reasons all right let's go through the medical literature again I found another reference by Sao in 2013. what he said was that true neurogenic thoracic outlet syndrome we'll discuss what that is later has an estimated incidence of only one person per million population now that's really low and he had gotten this from a surgeon at LSU I believe named gelat in 1970. and then Wilborn in 1988 also said there was an estimated incidence of one patient with true neurogenic TOS per 1 million people in the population and he referenced gelat in 1970. so let's go find July in 1970 an article called wasting of the hand associated with a cervical rib or band he provided no estimate of the incidents so right now I've got a very high number and I got a very low number and none of these have demonstrated any methodology about how they calculated the incidence but it seems like the medical literature is just repeating what others have said without verifying so here's another one I looked at Donna do in 2017. again he referred strictly to True neurogenic TOs he gave up a proportion of this he said all cases of neurogenic TOS true neurogenic TOS accounts for one percent of those meaning all patients with neurogenic TOS 99 had the disputed or non-specific form of TOS we'll get into this a little bit later he also quoted one patient with true neurogenic TOs per 1 million people in the population again what I consider to be a low number based on my experience and my knowledge of the experience of others in the country as well as the medical literature now he referenced a guy named ferranti from 2012. ferranti worked with Asa Wilborn same part of the people who came up with the division of true versus disputed neurogenic TOs Donna do also said in 2017 that if you had non-specific tus that would be 99 of all cases he gave no estimate of the overall incidence of neurogenic TOS as all those other papers nothing based on any data that I could find and he had referenced ferranti in 2012 who worked with Asa Wilborn the guy named Christo who I think is at MGH in Boston so let's go see what we find for ferranti in 2012 well all ferranti did was refer back to papers previous papers with Wilborn so again he gave no specific incidents no numbers no methodology so you can see where I'm going with this I am unable to find anybody who really came up with a measurement of how many people have neurogenic TOs Cristo the guy I mentioned just before he again mentioned that

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What can I do to calm my nervous system down if my body cannot currently tolerate exercise to correct the NTOS (posture)? I had recently sent a message to consult with Dr. Werden but was told that I am unable to consult with him directly due to being in another state. I am having a very hard time getting help with this and I have really bad muscle wasting in both arms / hands. I can barely write / type and don't have any personal help in my life. Any advice would be highly appreciated.