If you experience numbness, pain or other abnormal sensations in your neck, shoulders, or upper limbs after the Nuss procedure, it could be a sign of thoracic outlet syndrome (TOS). TOS occurs when important nerves and blood vessels, such as brachial plexus, subclavian artery, subclavian veion and pectoralis minor muscle get compressed as they pass through a narrow space of the chest. This narrow space is located between the clavicle and the armpit, usually formed by the first rib and the anterior and middle scalene muscles. While TOS is more commonly observed in orthopedic or neurosurgical patients, some individuals who have undergone the Nuss procedure may experience similar symptoms.

In the Nuss procedure, when the anterior chest wall is elevated, the distance between the ribs shortens, and the anterior chest wall shifts towards the head. This can easily lead to compression of the brachial plexus, subclavian artery, and vein near the thoracic outlet, causing numbness, pain, or other discomfort. Additionally, postoperative thoracic outlet syndrome (TOS) may have another cause. During the surgery, the patient’s arms are typically abducted, which straightens the nerves and vessels near the thoracic outlet. In this position, symptoms may arise due to compression from external forces.

If you develop TOS after the Nuss procedure, the discomfort can often be alleviated with measures that reduce pressure, such as acupuncture, massage therapy and so on. Severe pain, of course, may require additional medication for treatment. In most cases, symptoms gradually subside as the compression eases. However, if the nerves have sustained significant damage, recovery may take a longer time.