The medial antebrachial cutaneous nerve in thoracic outlet syndrome: A systematic review and meta-analysis

Abstract

Objective

This systematic review aims to evaluate the existing literature to ascertain the utility of MABC in diagnosing TOS and the prognosis of TOS patients who have undergone surgical intervention. By synthesizing the available evidence regarding MABC's role in this patient population, this review seeks to enhance risk stratification and inform treatment decisions.

Methods

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement for Reporting Systematic Reviews. Medline/Pubmed, Embase/Scopus, and Web of Science databases were queried for potential studies using the terms ("Medial antebrachial cutaneous nerve" AND "Thoracic Outlet Syndrome"). Inclusion criteria were studies published in peer-reviewed journals discussing the utilization of medial antebrachial cutaneous nerve conduction studies in the diagnosis and/or prognosis of Thoracic Outlet Syndrome.

Results

A systematic literature review yielded 10 manuscripts, which were included after a full-text review. We determined 137 symptomatic TOS limbs. Overall, 93 % and 84 % of TOS patients presented with sensory abnormalities and weakness, respectively. Overall, 92 % of patients had an abnormal MABC nerve amplitude prior to surgery. The overall effect size (Hedges g) for the meta-analysis of four studies was 1.80 with a 95 % confidence interval of (0.63; 2.97). Analyzing surgical outcomes, the compiled data indicate an overall improvement rate of 87 % in some sensory and/or motor functions.

Conclusions

Our review demonstrates the utility of MABC as a diagnostic tool. Furthermore, we emphasize the positive response expected from surgical intervention, highlighting that more studies are needed to determine the utility of MABC as a surgical outcomes prognostic tool.