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December 1963

Scalenotomy in Patients With and Without Cervical Ribs: Analysis of Surgical Results

Author Affiliations

Director (Dr. Shenkin) and Resident (Dr. Somach), Department of Neurosurgery, Episcopal Hospital.; From the Department of Neurosurgery, Episcopal Hospital.

Arch Surg. 1963;87(6):892-896. doi:10.1001/archsurg.1963.01310180008003

The syndrome of cervical rib causing pain in an upper extremity was described early in this century.1 Adson and Coffey2 in 1927 first pointed out that section of the scalene muscle alone could relieve a patient of pain due to the presence of a cervical rib. Thereafter it was reported that in some instances the scalene muscle of itself could cause compression of the brachial plexus and/or the subclavian artery in the absence of a cervical rib.3,4 Many confirmatory reports appeared, and some suggested that the scalene syndrome could be divided into primary and secondary varieties, depending on whether altered anatomical relationships would lead the scalene muscle to compress the neurovascular structures beneath it or whether a reflex spasm of the muscle due to pathological changes in adjacent areas was the etiological factor. However, other reports5-10 in the last 20 years question the efficacy of sectioning

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