Diagnosis and Treatment of Thoracic Outlet Syndrome (TOS)

Thoracic outlet syndrome (TOS) arises from compression of the neurovascular structures passing through the thoracic outlet, and presents across a broad clinical spectrum — from classic neurogenic TOS involving brachial plexus compression, to vascular forms affecting the subclavian artery or vein, to the widely debated “disputed TOS” in which symptoms persist without objective neurological abnormalities. The absence of universally accepted diagnostic criteria has long fueled controversy between neurologists and surgeons, and remains one of the central challenges in managing this condition.

In recent years, advances in high-resolution imaging — including ultrasonography, enhanced CT, and MRI — have opened new avenues for identifying structural findings that support a TOS diagnosis, even in cases where neurophysiological testing is inconclusive. At the same time, minimally invasive surgical techniques, including endoscopic-assisted transaxillary and infraclavicular approaches for first rib resection and scalene muscle release, have expanded treatment options and improved patient outcomes.

This Research Topic aims to bring together clinicians and researchers across neurology, orthopedic surgery, vascular surgery, radiology, and rehabilitation to advance the understanding, diagnosis, and treatment of TOS. We welcome contributions that address, but are not limited to, the following themes:

-Imaging-based diagnosis of TOS: ultrasound, enhanced CT, MRI, and -Neurophysiological assessment: nerve conduction studies, EMG, and their role in differentiating TOS subtypes
-Neurogenic, vascular, and disputed TOS: diagnostic criteria, clinical features, and patient outcomes
-Surgical management: transaxillary, infraclavicular, and endoscopic approaches; first rib resection and scalene release
-Sports-related TOS: prevalence, diagnosis, and return-to-play outcomes
-Complications, recurrence, and long-term follow-up after TOS surgery
-Multidisciplinary approaches bridging neurological and surgical perspectives

We welcome Original Research, Systematic Reviews, Reviews, and Opinion articles from researchers and clinicians worldwide.