My type of TOS--
Alison, I was told that I predominately have neurogenic and arterial TOS but that I also have TOS of the subclavian vein. The surgeon told me that this is rare-that people usually have one or the other but not both. However, the rib, scalene and fibrous band removal seems like the treatment for both--even though he showed me that the vein travels a diff path than the nerves and artery.

Two incisions--
I was told by the surgeon that they go in under the arm to get the front part of the rib and then also through the back of the neck to remove the back part of the rib. I also thought this odd-- and a bit disconcerting seeing as I have neck issues and have had prev. neck surgery and also since I don't want to encourage any reason for more scapular pain.

Types of Scalenectomy---
Yes, I realize that there are diff approaches. As a layperson I don't know how to choose--but I did hear fr 1 surgeon that the free-floating approach isn't a good idea; I was told that some people have pain from the jagged edges. (Same goes for jagged edges of partial rib removal.) Since I don't have anything to go on I think it best to choose the surgeon and then go with their approach--excluding the hanging muscle approach. Regardless of being a layperson, it just seems senseless not to cut it out entirely or attach the hanging muscle somewhere!

Vic--where oh where did your scalene go? I am sorry you are in so much pain! I wonder if an ultrasound would be beneficial to you? Did you read Jokat's link to a paper written by Jordan about it? They could see mine on the ultrasound I just had. Also the fibrous bands. The ultrasound is much less expensive and is available in more places.

PT post op...------
Yes thx Alison, I know its a whole diff kind, but wouldn't you expect a 70yo doc who's done these procedures over his career to have figured out the benefit of PT? I asked specifically and he said he Almost Never orders PT unless there is a problem. He didn't know of any neurologists to refer me to , he never heard of Lyrica, he didn't know of any PTs to refer me to. He says he & his dept invented this surgery and I expect it's good--but that newer options are better. And he said that some people don't get better, some get worse, and all he could do is refer them to a pain clinic.

thx much for the input. trying to rest easy and hope to make a decision soon.