Thoracic Outlet Syndrome Clinic
约翰霍普金斯大学胸廓出口综合征诊所诊断和治疗各种形式的胸廓出口综合征, 无论是神经源性(神经压迫)还是血管性(血管压迫). Our experts study your medical history, run tests to rule out similar conditions, 给你检查一下，弄清楚是什么导致了你的手臂和肩膀的症状.
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Our Specialists
Meet the experts who diagnose and treat thoracic outlet syndrome.
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What You Need to Know
Learn more about symptoms, treatments and prevention.
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Patient Information
Learn about what to expect, from your first visit to your last treatment.
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Clinic Locations
View our Baltimore clinic locations.
What is Thoracic Outlet Syndrome; How is it Diagnosed and Treated?
Assistant Professor of Surgery Dr. 应伟林讨论胸廓出口综合征的病因、症状及危险因素.
Patient Information: What to Expect
Personalized Treatment
Treatment for thoracic outlet syndrome (TOS) is highly specific to each patient. 专家诊断对于确定神经或血管是否受到压迫以及哪些骨骼或肌肉受到压迫至关重要. If possible, 一开始通常建议采用保守治疗，特别是对于神经源性TOS，只有当你不能通过保守措施获得永久缓解时，才会进行注射或手术.
What to Expect from Your First Visit
Your care team will begin by conducting the following:
- Complete medical history
- Physical examination
- Discussion of symptoms
Thoracic outlet syndrome can sometimes be caused by weight gain, increased muscle mass, injury or repetitive overhead motion. 为了更好地了解可能导致您症状的原因，您的护理团队还可能会询问:
- Work and lifestyle activities
- Recent injuries or changes
Appropriate diagnostic scans may then be performed.
What to Expect from Your Treatment
您的护理团队将根据您的TOS类型制定定制的治疗计划, the severity of your condition, and previous treatments you have received. TOS treatments include:
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神经源性TOS的一线治疗是物理治疗，这是最常见的类型. Often it’s the only treatment many patients will need. We provide a set of written instructions you can bring to a physical therapist, or you can visit the Johns Hopkins Medicine Department of Physical Medicine and Rehabilitation.
Length of treatment: 正常的治疗过程是6到10周，每周2到3次. 如果物理治疗没有提供缓解，你可以回到诊所进一步治疗.
Resuming activity: 如果你的症状在正式的物理治疗过程中得到控制，你将学习如何自己做“维护”家庭物理治疗练习来管理你的肩膀. 如果物理治疗成功，大多数推荐十大正规网赌平台都能恢复正常活动.
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If physical therapy doesn’t relieve your symptoms, further diagnostic tests, such as an initial injection of local anesthetic into the scalene muscles, may be recommended. If you respond to this diagnostic injection, then botulinum toxin may be helpful.
In this treatment, 少量肉毒杆菌毒素被注射到被认为压迫神经的斜角肌附近.
Length of treatment: In rare cases, a single-dose injection may give permanent relief. However, most treatments usually last two to three months.
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There are several different approaches to decompression surgery. Your vascular surgeon will opt for the one that best treats your condition.
Length of stay: Depending on the type of TOS and kind of surgery that is performed, 大多数推荐十大正规网赌平台在医院呆一天，手术后第二天就可以出院了. If you’re coming from out of town, you should expect to stay in Baltimore for two to three days before returning home.
恢复:大多数患者在手术后至少1-2周的恢复过程中会感到某种程度的不适/疼痛.
Return to activity: Patients often to return to light activity in seven to 10 days. Returning to work, therefore, will depend on the physical demands of the job. 我们强烈建议你在三个月内不要做任何重复的头顶运动或举重超过10到15磅.
Physical therapy: The course of physical therapy begins two weeks after surgery. We recommend you attend two to three sessions per week, for eight to 12 weeks. You can visit a physical therapy practice that is convenient for you. 您将获得具体的书面物理治疗说明，并提供给您的治疗师.
Clinic Staff
Asma Abeer, M.S., PA-C
Physician Assistant
Asma Abeer在新泽西州Ramapo学院获得生物学学士学位，辅修老年学. 随后，她在德萨莱斯大学(DeSales University)获得了医师助理研究硕士学位. Following graduation, 阿斯玛加入了约翰霍普金斯大学湾景分校的血管外科，并一直在那里工作. Asma主要管理门诊围手术期患者，并协助住院血管患者.
Holly Grunebach, P.A.-C., M.S.P.H.
Physician Assistant
Holly Grunebach在宾夕法尼亚州的Slippery Rock大学学习生物学和舞蹈, 然后获得了阿卡迪亚大学的医师助理研究硕士学位和公共卫生硕士学位. After a year of emergency-room work, Holly entered the Postgraduate Surgical Residency for Physician Assistants program at The Johns Hopkins Hospital. For the last five years, she has worked in the Division of Vascular Surgery. Holly has spent much of that time in the Thoracic Outlet Syndrome Clinic, assisting surgeons in the operating room and at the clinic.
Lindsay Keilholtz
Triage Nurse
林赛在弗吉尼亚联邦大学(VCU)获得了护理学士学位。. 她的职业生涯始于VCU医疗中心，在心脏医学重症监护室担任护士，在那里工作了两年. 林赛于2009年加入约翰霍普金斯大学，担任心血管外科重症监护病房的护士，照顾心脏手术患者, 在ICU培训新护士，并为年轻员工提供临床资源护士. In 2015, Lindsay became the second triage nurse for the Department of Surgery, working with the cardiac and vascular surgery teams. 她还担任约翰霍普金斯大学心脏和血管研究所所有新心脏和血管患者的第一联络点.
Our Locations
Johns Hopkins Bayview Medical Center
4940 Eastern Ave
Baltimore, MD 21224
The Johns Hopkins Hospital
1800 Orleans St
Baltimore, MD 21287
Suburban Hospital
8600 Old Georgetown Rd,
Bethesda, MD 20814
Surgical Treatment for Thoracic Outlet Syndrome | Mark’s Story
马克·诺里奇决定找到一种治疗胸廓出口综合征的方法，这样他就可以开始大学橄榄球项目了. The Norwich family traveled from New York City to Baltimore to see Dr. Ying Wei Lum. Mark and his family tell the story of the surgical treatment, rehabilitation and recovery from thoracic outlet syndrome.
Treatment for Thoracic Outlet Syndrome | Aaron's Story
Aaron Hoover first felt the shoulder pain while pitching in a college baseball game. After numerous tests and scans, 亚伦的医生发现了一个血凝块，这是他患有胸廓出口综合征的主要线索. Aaron谈到了他在约翰霍普金斯胸廓出口综合征诊所的经历, from surgery to recovery.
Transaxillary First Rib Resection for Thoracic Outlet Syndrome (TOS)
从约翰霍普金斯大学胸廓出口综合征诊所了解更多关于经腋窝第一肋骨切除术治疗TOS的手术方法. Watch to find out what happens during and after this decompression surgery, 对于被诊断为神经源性或静脉性TOS的患者，哪一种手术治疗是低风险和有效的.
Nerve Block Treatment for Thoracic Outlet Syndrome (TOS)
神经阻滞是胸廓出口综合征(TOS)患者的一种非手术治疗方法。. 这个动画演示了约翰霍普金斯胸廓出口综合征诊所的医生如何使用A型肉毒杆菌毒素注射进行斜角肌间臂丛阻滞，为患者提供暂时的疼痛缓解.
