I don't think the anterior or middle scalene muscle attaches to the spine, Michael....so the hope is that once resected away from that first thoracic rib, they will both simply atrophy up the cervical spine without causing any further problems for you. Gelabert probably explained that what can sometimes happen instead, is that one or the other finds a way to reattach itself by way of scar matter to another soft structure within the outlet or to the pleura or some other fun place where the popular kids hang. If yours is the type of body that forms a lot of scar tissue (I'm genetically gifted in that way, myself) you may be more prone to this and it's good to be aware of in your post op recovery and rehab phases so that your PT, OT, bodyworker, etc. can help you to prevent or discourage it from forming (Sharon Butler has a good kit out right now <+/- $40.>, her website and book/s have some interesting stuff about fascia and TOS if you're interested). I'm hoping of course you won't need a re op....personally (and assuming you're not lifting weights or at least are backed way off from before and are gradually trying to get to where you can start to strength-train again - PT has to be done with a TOS protocol, as I'm sure you know) when and if you're ready for a surgical opinion I'd probably see Donahue, Illig, Pearl or Thompson as well as one of the "UC" people (Gelabert, Freischlag, Humphries, or the 2 at Johns Hopkins in Baltimore), simply to get a genuine different perspective. I don't pretend to know where you're at with things, just sorry to hear you're still suffering and I sure know what that's like. Believe you me.