Scalenectomy
 

Hi there- I will be doing a scalenectomy only surgery as well. Mine is scheduled for Olctober...

why not the rib too?
most docs take that out to make room for scar tissue that will form

My doc doesn't think I need it. I had a positive scalene block and he also said that in many of the surgeries he has seen a artery or fiber our bands rubbing on top of the brachial plexus.
I am going to talk to some of his patients before the surgery next month.

i would get a 2nd and 3rd

Surgery. 1979 Jan;85(1):109-21.
Scalenectomy versus first rib resection for treatment of the thoracic outlet syndrome.
Sanders RJ, Monsour JW, Gerber WF, Adams WR, Thompson N.
Abstract
Five years ago a follow-up study of first rib resections disclosed a recurrence rate of over 15%. Many patients were reexplored supraclavicularly, and in every case the anterior scalene muslce was found to be reattached to the bed of the first rib. Scalenectomy invariably was successful, which led to this study of scalenctomy as the first operation for all cases of persistent thoracic outlet syndrome (TOS). The study revealed that most patients with TOS gave a history of neck trauma and had symptoms not only of paraesthesias of the hands and weakness of the arms, but also of neck pains and headaches. The common physical findings were tenderness over the scalene muscles and duplication of symptoms with the arms raised. A scalene muslce block with a local anesthetic was the most useful diagnostic test. The good-to-excellent long-term results following 239 scalenctomies and 214 first rib resections were almost identical, 68% and 70%, respectively, with fair results in 20% and 13%, respectively. In patients with a history of neck trauma followed by headache, neck pain, arm weakness, and parasthesias in the hand, anterior and middle scalenectomy should be considered. On the other hand, first rib resection is recommended for patients with no history of neck trauma and symptoms limited to the arm and hand, particularly those patients with signs of arterial or venous insufficiency.

And isn't getting the rib removed a more traumatic surgery? More cutting and more scar tissue and more things to workaround as the rib is removed.

Good luck with your scalenectomy, @per834.

note when this article was written-1979! Good Luck with your surgery-Scalenctomy is definatly less invasive-but I would get a 2nd opinion too. If you do go ahead keep us posted about your recovery.

Is there a newer study that covers the same topic?

Yes- one done in 1992 basically said the same thing

I had scalenectomy without rib resection for TOS (R) in 2002 and (L) in 2010. I had scar tissue issues in the L for about 3 years but after break up of scar tissue and therapy I am absolutely fine now. The medical community here in America does not like to to do only scalenectomies as it is not called a complete surgery even though in Europe and other parts of the world Dr's are opting to do scalenectomies in cases that they feel are good candidates for scalenectomies only. I am back to all my normal functions including walking my dog and playing fetch games with him and picking up the 2 gallons of milk from Costco without any pain or symptoms. I am not on any pain medication either. I got off Gabapentin this March and I am still good.
Ofcourse everyone' case is different, I am not against rib removal if needed. I almost had my ribs removed in St. Louis last August. But it was not necessary as proven in my case.
Good luck with your surgery with whatever you decide.