Does anybody know why the space between the collar bone and the first rib cannot be opened-up and a permanent spacer installed to keep them apart? This would seem a simple solution for TOS.

That's interesting...thinking outside the box.

But I think if it is caused by long time postural & uses - those would still have to be addressed to also help repair & maintain.

I mean something like angioplasty :
http://www.youtube.com/watch?v=S9AqBd4RExk

But outside the blood/nerve vessel, so it will maybe just hurt a little on the thoracic outlet area because of stretched tissue but that all

I have send an email at some surgeons to as the question.

What I understood in my family's case, the rib was removed, a scalene, to open the space.
From the truma of the injury; a whiplash type spasm...there are short bands from the neck to the collarbone that support the neck...

The doctor, noted that one of the bands was first noticed in the surgery in the area of the armpit caught in a muscle spasm. It was detached and snaked up into the body....it was next found during the second part where the area along the collar bone as opened to detach the rib from the spine area....

It was here he found the other end, it was measured at only 1 1/2 inches long.
THat was a long stretch...

BUT also, a gortex material was wrapped around each of the vessels to protect them from future scarring or injury.
When symptoms returned, a redo clean up was done. During this proceedure it was found that the scar matter (adhisions) had just spider webbed around all the vessels and entaggled itself anyway.

So I am not sure if like running a conduit around these vessels would do more harm then good if the scarring matter is going to grow anyway.
Just my thoughts,
di

Not exactly sure if the question you ask and the solution you're alluding to are exactly the same thing. However, anything introduced into the space between the first rib and clavicle would potentially make things worse, as there are no attachments between these two independently movable structures. Anything attached to either structure would only cause more impingement. "Spacers" are used between two attached structures, such as vertebral discs.

The only potentially surgical options for making more space would be removal of the first rib or clavicle - which most patients (and surgeons) would not be willing to do. Orthopedic surgeons would be the appropriate specialist to consult with on this. Most patients have better success with a physical therapist familiar with TOS.

Angioplasty basically involves placing a tube (a stent) within another tube (a blood vessel) to keep it open, so there really is no comparable analogy to an open space as described above.

I'm not sure how you came upon my name or e-mail, so please understand that the information offered above is not intended to diagnose or treat any specific person or condition, as each case should be evaluated on its own merits with a face-to-face consultation.

Regards-

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