History of Thoracic Outlet Syndrome

This history of thoracic outlet syndrome comprises a series of short and colorful stories. If we weave together these short stories, we can read a fascinating epic.

Exactly 200 years ago, Sir Astley Cooper first described thoracic outlet syndrome. Later, in 1861, Holmes Coote performed the first TOS surgery. When Roentgen produced the first medical x-ray in 1895, the cervical rib syndrome was born.

Many famous names form the fabric of the TOS story. In the late 1880s, Paget and von Schroetter first described blood clots and venous TOS. Halstead tried to prove the mechanism of subclavian artery aneurysm formation. Jones first described neurogenic TOS in the late 1880s.

Many researchers tried to unravel the mechanism of TOS. During the 1920s, Law discovered soft tissue bands, and Adson addressed the anterior scalene muscle. Then in the 1930s, Naffziger and DeBakey focused on the anterior scalene muscle. Later, in the 1940s, Eden proposed nerve compression between the rib and clavicle. Further, Falconer, Wright, and Lord induced TOS with arm movement and posture changes.

In 1956, RM Peet all of these syndromes under the name, ‘thoracic outlet syndrome.’ Two years later, Rob and Standeven coined the similar, ‘thoracic outlet compression syndrome.’

Next, in the 1960s, Roos performed the transaxillary first rib resection. Later, in the 1970s and 1980s, Stoney, Sanders, and others advanced the supraclavicular approach.

A famous argument erupted in the late 1980s between Wilbourn and Roos. Wilbourn coined the term ‘disputed TOS.’ To this day, some doctors still use this term to deny the diagnosis of TOS. In reality, our knowledge of TOS has progressed far beyond this simplification. The term ‘disputed TOS’ has faded into the dustbin of history.

The history of thoracic outlet syndrome serves a lesson for all who are willing to learn from it.