I think this is more true than any of us readily realize. TOS by definition is not an accepted disorder or disease, it is a "SYNDROME" and that is defined as a collection of symptoms and/or signs. There is ALWAYS an underlying disorder/disease. Since the brachial plexus area is so complex, there are many,many possible underlying disorders, many very difficult to readily identify. Many of us have more than one underlying disorder, some have exclusively different disorders, but we still match the collection of symptoms/signs called Thoracic Outlet Syndrome.

Medical imaging capability is growing exponentially, and I think "exploratory" surgery will become a relic of the past in the near future. Hopefully we'll rarely hear "We won't know until we get in there."

I am not in the industry, but I would highly advise anyone contemplating major surgery in an area as complex as the brachial plexus, get the best scans that you can, even if it means travelling for the scan. It will provide your surgeon with essential information. If there are any anomalies of nerve or vascular locations, your surgeon will know where to look to visualize these and avoid complications.