Arthroscopic Treatment of Isolated Pectoralis Minor Syndrome After Two Unsuccessful Cervical Spine Procedures: A Case Report.

Pectoralis minor syndrome (PMS) is an uncommon cause of neurogenic thoracic outlet syndrome and is frequently overlooked because its clinical manifestations resemble cervical radiculopathy and other shoulder disorders. We report a case of a 67-year-old female who developed persistent upper-extremity pain and paresthesia despite undergoing two cervical spine procedures. Following comprehensive clinical evaluation, provocative testing, and brachial plexus magnetic resonance imaging, isolated PMS was diagnosed. The patient underwent arthroscopic pectoralis minor tenotomy combined with suprascapular nerve release and brachial plexus neurolysis, resulting in marked pain relief, functional recovery, and return to recreational activities after one year. This case highlights the importance of considering PMS in patients with persistent symptoms after cervical spine surgery and supports arthroscopic decompression as an effective treatment in carefully selected patients.