Quote:
Originally Posted by nospam
I'm guessing the Dr. he mentioned from John's Hopkins is Julie A. Freischlag who trained and worked at UCLA with Gelabert, Ahn, Jordan, and Angle.
I think the scalene block procedure is unnecessary for diagnostics since you have multiple cervical ribs. All the surgeons in L.A. do not rely on the scalene block for diagnostics. Sam Ahn and Niren Angle (Orange County) do not as they have found that negative results do not rule out TOS (as was the case with me).
Why do you say 50% of those with TOS suffer from pec minor syndrome? Most of the surgeons I consulted did not believe in the necessity of the pec minor surgery (either never heard of it or never done it). I believe Dr. Sanders and his protege Annest in Denver led the charge regarding pec minor tenotomy. Dr. Thompson in St. Louis performs it as well. I haven't found any others who do. The outcomes of the pec-minor procedures are not overly positive in this forum. While I get compression at the pec-minor, they are able to release it in therapy (and I have learned some self release techniques). Do a search on this forum to see some of the downsides of having the pec minor surgery.
In regards to neurolysis, scarring/adhesions can develop from inflammation and edema. You definitely want to choose a surgeon who is prepared to perform the surgical neurolysis if necessary.
Great write-up BTW  |
Marc, Sorry I didnt mean that all the dr's rely on it solely,but all 3 surgeons that i saw including Ahn,but especially Gelabart and Mckenna,were very interested in the fact that it was positive and seemed to rely on it
for me.Ahn wanted to do his angiogram test. Mckenna suggested an MRA,but wasn't necessarily recommending it.Thats why I would want to do the scalene block again if I was going to pursue surgery. I havent seen Angle.(I dont consider him "in L.A.")
Parbie ,If you think it is the pec minor,you could also look into the MAC test. its the nerve test that tests for pec minor involvement. I am still considering this too as I think I have pec minor involvement too. The PT definatley helps me with this too. And yes I think the Pec Minor Tenomoty is still controversial because not that many dr's do it. Ahn will do it if he finds out that is where the compression is based on his angiogram test.
Since you know you have cervical ribs, the first thing I would think they would want to do is to take them out and once they are there they can see what else if anything is going on. Weather they do full scalenectomy or neuryolosis does seem to depend on the dr.