Surgical techniques: Pectoralis minor tenotomy for NTOS

Chandu Vemuri, Robert W. Thompson

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

1 Scopus citations


Neurogenic pectoralis minor syndrome (nPMS) (Chap. 15 is caused by compression of the brachial plexus in the sub-coracoid space by the pectoralis minor tendon. Nerve compression at this level can cause significant symptoms of neurogenic TOS, and may be the dominant symptom generator over compression at the scalene triangle. Untreated nPMS may be the underlying etiology in persistent or recurrent symptoms following operations for neurogenic TOS and therefore may explain a proportion of surgical failures. Moreover, it is now apparent that a significant number of patients may have a clinical diagnosis of neurogenic TOS represented by isolated brachial plexus compression at the level of the pectoralis minor muscle, for whom isolated pectoralis minor tenotomy may provide a minimally-invasive surgical option associated with rapid postoperative recovery and a high likelihood of clinical success. Recognition and treatment of this condition has therefore been an important step in our evolving understanding of neurogenic TOS. In this chapter, we will provide a description of the common open surgical techniques for the treatment of nPMS.

Original languageEnglish
Title of host publicationThoracic Outlet Syndrome
Subtitle of host publicationSecond Edition
PublisherSpringer International Publishing
Number of pages7
ISBN (Electronic)9783030550738
ISBN (Print)9783030550721
StatePublished - Jan 25 2021


  • Brachial plexus
  • Coracoid process
  • Nerve compression
  • Pectoralis major muscle
  • Thoracic outlet syndrome


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