When I first got diagnosed I was interested in Scalenectomy only and did alot of research and being on this forum for 2 years listening to peoples experiences has taught me alot.

In my research, some neurosurgeons do scalenectomy only. Dr Brown at UCSD and Dr. Sanders are proponents of this. And Poss Dr. Johanson in Seattle.I think it only works if you are sure if it is your scalenes that are the problem, and in many cases I think this can be resolved with PT/injections etc.

The more common practice is to take the rib out and cut the scalenes, and this is usually done by a Vascular or Thoracic surgeon. Some Docs will do more like Dr. Thompson. Some do Pec Minor Tenomotys. If you have a cervical rib they will (or should) take that out if it is the cause.

Since it is so hard to figure out where the problem is and in some cases multiple issues, I beleive Ideally, the best Docs will determine what exactly the problem is and do the surgery accordingly. This seems very hard to find-Dr. Donohue in Boston seems to be one-poss Thompson and Pearl.

This is just my opinion.In my case, I realized thru PT that my ribs were causing many of the problems. Once I got my ribs back in place-my scalenes and pec minor got better. I still have to do mobilizations and stretches to keep it in check. My Trapezious muscles are still tight as rocks and I still get nerve flares in my neck and Traps, but that my be more related to a bulging disk and bone spurs. this complicates matters and is what is called double crush syndrome.

Good Luck.