You need to find a TOS expert, usually the surgery to remove the extra cervical ribs has better results than those with unknown cause of TOS.
But best surgeon you can get is always a good idea..
Our TOS forum-
http://neurotalk.psychcentral.com/forum24.html
sticky threads -
DOCTORS & PTs List and saved PT info threads -
http://neurotalk.psychcentral.com/thread135.html