Clinical Incidence and Prevalence: Basic Data on the Current Scope of the Problem

The incidence and prevalence of TOS in the US is somewhat of an enigma, largely due to the absence of objective criteria for diagnosis and inconsistent reporting standards, but there are approximately 2,000 to 2,500 first rib resections performed in the US per year. This is a disease of younger individuals that has significant impact on the working cohort and can lead to significant disability and lost productivity if not recognized and treated. Surgery done for TOS in the United States is performed mostly for neurogenic reasons, and with excellent outcomes as a whole. Morbidity and mortality is minimal, and the majority of operations are being performed by vascular surgeons. The best outcomes are found in centers of higher volume and in teaching institutions. A better understanding of the incidence and prevalence of this condition will help the primary care physicians who initially hear about vague complaints and symptoms and must recognize these quickly enough to refer to the appropriate specialist for prompt therapy.