Abstract
True neurogenic thoracic outlet syndrome (nTOS) is a rare condition resulting from
brachial plexus compression, frequently associated with congenital anomalies such
as cervical ribs or fibrous bands. We report a unique case of nTOS involving both
a cervical rib and fibrous band, complicated by an incidental intraoperative finding
of a fascicular rupture in the lower part of lower trunk. Notably, the patient had
no history of trauma but had undergone multiple sessions of manual therapy and a single
extracorporeal shockwave therapy to the cervical region, raising concerns about a
potential iatrogenic contribution.
Keywords
true nTOS - brachial plexus - fascicular rupture - cervical rib - lower trunk injury
