Introduction: Thoracic Outlet Syndrome (TOS) arises from compression of neurovascular structures leaving the thoracic outlet. 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 undergone surgical intervention. By synthesizing the available evidence regarding MABC, we aim 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. 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 included studies published in peer-reviewed journals discussing the utilization of medial antebrachial cutaneous nerve electromyography in the diagnosis and/or prognosis of Thoracic Outlet Syndrome
Results: A systematic literature review yielded 91 articles, of which 36 were unique. After abstract and full-text review, 26 articles were excluded from the analysis, and 10 articles were included. A total of 259 patients were identified in the literature to have presented with a diagnosis of TOS with a weighted average of 30.5 years. 73.75% of the population was female. Overall, 93% and 79% of TOS patients presented with sensory and weakness deficits, 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 4 studies was 1.80 with a 95% CI of (0.63; 2.97). Analyzing surgical outcomes, the compiled data indicate an improvement rate of 87% in some sensory and/or motor functions.
Conclusion : Our review presents an updated meta-analysis for MABC nerve amplitudes which highlights its utility in diagnosing TOS. Furthermore, we emphasize the positive response expected from surgical intervention, highlighting that more studies are required to determine the utility of pre- and post-surgical intervention MABC.
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