血管胸廓出口綜合徵：病例報告
Eric ChuKing Yi LeungLucina Lo Wah NgAda Yuk Yin Lam
胸廓出口綜合徵，保守治療
目的：探討一例血管性胸廓出口綜合徵患者的脊醫治療。
臨床特徵： 一名 30 歲男性報告右手突然出現間歇性麻木、緊繃和無力。表現為右上肢皮膚片狀剝落，右肩紫紺；以及冰冷蒼白的右手。運動被確定為激發運動。骨科檢查顯示艾倫測試呈陽性，而 Adson 測試結果有所改變。他的右肘/腕屈肌和伸肌的運動強度為 4/5，右側第 5 掌骨的屈肌和外展肌明顯弱於左側。他之前曾被神經科醫生診斷出患有胸動脈出口綜合徵，並給他開了肌肉鬆弛劑、物理治療運動、按摩治療和針灸治療。
干預和結果：治療方案包括脊柱推拿療法、熱超聲檢查、器械輔助軟組織鬆動和伸展加壓牽引。他的症狀完全消失了，他反復進行的胸廓出口綜合徵和頸椎前凸的骨科檢查都正常。
結論：一名 30 歲男性血管胸廓出口綜合徵通過脊醫治療。
參考
1. Jones MR, Prabhakar A, Viswanath O, et al. Thoracic outlet syndrome: a comprehensive review of pathophysiology, diagnosis, and treatment. Pain Ther 2019;8(1):5-182. Sanders RJ, Hammond SL, Rao NM. Diagnosis of thoracic outlet syndrome. J Vascular Surg 2007;46(3):601-6043. Huang JH, Zager EL. Thoracic outlet syndrome. Neurosurg2004;55(4):897-9034. Lo CC, Bukry SA, Alsuleman S, Simon JV. Systematic review: The effectiveness of physical treatments on thoracic outlet syndrome in reducing clinical symptoms. Hong Kong Physiother J 2011;29(2):53-635. Qaja E, Honari S, Rhee R. Arterial thoracic outlet syndrome secondary to hypertrophy of the anterior scalene muscle. J Surg Case Rep 2017;2017(8)6. Thompson JF, Jannsen F. Thoracic outlet syndromes. Br J Surg 1996;83(4):435-4367. Yuschak E, Haq F, Chase S. A case of venous thoracic outlet syndrome: primary care review of physical exam provocative tests and osteopathic manipulative technique considerations. Cureus 2019;11(6)8. Povlsen S, Povlsen B. Diagnosing thoracic outlet syndrome: current approaches and future directions. Diagnostics 2018;8(1):219. Murphy DR, Hurwitz EL, Gregory A, Clary R. A nonsurgical approach to the management of patients with cervical radiculopathy: a prospective observational cohort study. J Manipulative Physiol Ther 2006;29(4):279-28710. Chu EC, Chan AK, Lin AF. Pitting oedema in a polio survivor with lumbar radiculopathy complicated disc herniation. J Family Med Prim Care.2019;8(5):1765-176811. Kim J, Sung DJ, Lee J. Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. J Exerc Rehabil 2017;13(1):12-2212. Chu EC, Lim T, Mak K. Cervical Radiculopathy alleviating by manipulative correction of cervical hypolordosis. J Med Cases 2018;9(5):139-14113. Berry RH, Oakley P, Harrison DE. Alleviation of radiculopathy by structural rehabilitation of the cervical spine by correcting a lateral head translation posture (-TXH) using Berry translation as a part of CBP Methods. A case report. Chiropr J Australia 2017;45(1):63-7214. Hooper TL, Denton J, McGalliard MK, Brismée J, Sizer PS Jr. Thoracic outlet syndrome: a controversial clinical condition. Part 1: anatomy, and clinical examination/diagnosis. J Man Manip Ther 2010;18(2):74-8315. Sanders RJ, Pearce WH. The treatment of thoracic outlet syndrome: A comparison of different operations. J Vasc Surg 1989;1 0(6):626-63416. Jones MR, Prabhakar A, Viswanath O, et al. Thoracic outlet syndrome: a comprehensive review of pathophysiology, diagnosis, and treatment. Pain Ther 2019;8(1):5-18