Thought on this question, these are just my opinions, please form your own:

If I were a young healthy person who has had TOS for less than three years, only had it on one side, and had it related to some sort of activity I engage in, baseball, violin, etc... I would go to Dr. Pearl.

If I had TOS from a CAR ACCIDENT for less than five years, and had bilateral TOS for less than 5 years, still had an open court case sueing the pants off someone and/or was awarded lifetime medical treatment I would go to Dr. Sanders/Dr. Machenic/Dr. Annest. Dr. Machenic is the best neurologist to do a nerve conduction test on me thus far. I have had at least 7 done...anyway, he nailed it exactly, naming exactly which tiny muscles in my hands have started to waste away. He actually gave explanation for the reason I was losing my fine motor skills AND determined if I did have surgery, that as far as my nerves go, it should go well, because they were not actually damaged, only compressed.

If I had TOS that didn't meet condition one and lived near St. Louis, I would go to Dr. Thompson. He is passionate about his work, and very experienced.

If I had TOS for more than 10 years, or have had previous unsuccessful surgeries, If I was a "difficult case", or if I had been turned away by any of the surgeons above I would go to Dr. Donahue.

Also, I would first have Botox of the scalenes And pec minor along with physical therapy as a treatment method in retrospect. I wish I had done this 10 years ago, but things were different then. Info on the pec minor really started in 2005. I would insist on having a pec minor release with the first rib resection/scalenectomy. Dr. Sanders work in this area is phenomenal. The pec minor release should always be part of the big surgery IMHO. More stress should be put on pec minor syndrome for tos patients.

With regard to entry through the armpit vs. above the colar bone, I would go with whatever the surgeon prefers. Whatever they prefer is what they are most comfortable with. Would you rather drive a car with the seat positioned the way you like it, or the way your passenger likes it?


There seems to be a lot of people on the west coast that are a little lost with regard to surgeons, especially California. Can some people give some insight to their opinions of doctors out there???