Misdiagnosed, Misunderstood, & Feared: Thoracic Outlet Syndrome

In this presentation, Dr. Bryan Burt, Associate Professor, Department of Surgery, Division of General Thoracic at Baylor College of Medicine, discusses thoracic outlet syndrome (TOS) with special focus on neurogenic thoracic outlet syndrome (nTOS). He outlines the pathophysiology, diagnosis, conservative and surgical treatment, outcomes reporting, and the legal risk to surgeons who treat nTOS.

Dr. Burt describes his multidisciplinary approach to the diagnosis and treatment of TOS, involving Pain Medicine and Rehabilitation, Neurology, and various surgical specialties. He highlights first rib resetion as a strategy for the treatment of TOS and describes the supraclavicular approach for first rib resection in detail with an operative procedure video. 

CME Information

CME Credit Available

You may claim CME credit after watching this activity.

Needs Statement

General, plastic, thoracic, vascular, cardiothoracic,and abdominal surgery physicians, residents, fellows and medical students need to be regularly updated on advances in surgical care and clinical practices that will aid them in performing a variety of surgical procedures to increase the patient care experience and improve practice efficiency.


At the conclusion of this activity, the participant should be able to:

  • Discuss the anatomy and pathophysiology of thoracic outlet syndrome (TOS).
  • Evaluate the diagnostic criteria required to make a diagnosis of neurogenic TOS.
  • Discuss the treatment strategy for neurogenic TOS.

Target Audience

  • Physicians
  • Medical Students
  • Fellows
  • Residents
  • Nurses
  • Other Health Professionals

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Program Director

S. Rob Todd, M.D.
Department of Surgery, Division of General Surgery
Baylor College of Medicine
Houston, Texas
Disclosure: Nothing to disclose.

Term of Approval

August 1, 2019 through August 31, 2021. Original release date: August 1, 2019

Disclosure Policy

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial SupportSM, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: 1) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.


The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:


  1. Bryan Burt, M.D., FACS

    Bryan Burt, M.D., FACS

    Associate Professor of Surgery
    Baylor College of Medicine


    Nothing to disclose.

CME Credit Available

You may claim CME credit after watching this activity.

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  1. Bryan Burt, M.D., FACS

    Bryan Burt, M.D., FACS

    Associate Professor of Surgery Baylor College of Medicine