Diagnostic Dilemmas and The Benefit of Robotic-Assisted Surgery in the Management of Neurogenic Thoracic Outlet Syndrome in Complex Patients.

A 64-year-old male patient presented with progressive, debilitating bilateral arm pain for 2 years following traumatic cervical spine injuries requiring multiple operations. Despite extensive diagnostic workup by several specialists, he was left without a diagnosis, treatment plan, or ability to perform his job. He was diagnosed with bilateral neurogenic thoracic outlet syndrome, based on clinical diagnostic criteria. A 2-staged bilateral robotic first rib resection resulted in complete resolution of his symptoms.