Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 07-26-2013, 11:55 AM #1
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Default Scalenectomy

Hi there-
Has anyone had positive results from a scalenectomy?
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Old 07-27-2013, 01:21 PM #2
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Question

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Originally Posted by per834 View Post
Hi there-
Has anyone had positive results from a scalenectomy?
Why would someone have just a scalenectomy? Never heard of this just curious!
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Old 07-27-2013, 06:47 PM #3
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Some doctors who are proteges of Dr. Sanders do the scalenectomy only. I believe the doctors at University of California, San Francisco, prefer to do the scalenectomy only. I remember seeing an article a few years ago that said that the surgical outcomes of scalenenctomy and scalenectomy/rib resection were comparable.
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Old 07-28-2013, 12:21 PM #4
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Default 22 years ago

I had a scalenectomy on one side 22 years ago at UCSF and have been on disability ever since. I think nowadays it is probably more common to remove a rib as well but that's how they did it back then. I still have less pain in my nonsurgical arm so I've never had any further surgeries.
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Old 07-28-2013, 02:02 PM #5
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Coop42,

I had a scalenectomy/rib resection across town in another hospital in SF. I've been disabled since then too. I'm not impressed by the results of either procedure.

Take care,
Kelly
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Old 07-28-2013, 04:03 PM #6
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If a scalene is showing as being the main issue, it should be fine to go that route.
It could be unusually large or in a different position..we are not built exactly the same as the medical books & images may lead us to believe.
There are slight variances in our anatomy.
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Old 07-30-2013, 12:38 PM #7
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Default Scalenctomy only

When I first got diagnosed I was interested in Scalenectomy only and did alot of research and being on this forum for 2 years listening to peoples experiences has taught me alot.

In my research, some neurosurgeons do scalenectomy only. Dr Brown at UCSD and Dr. Sanders are proponents of this. And Poss Dr. Johanson in Seattle.I think it only works if you are sure if it is your scalenes that are the problem, and in many cases I think this can be resolved with PT/injections etc.

The more common practice is to take the rib out and cut the scalenes, and this is usually done by a Vascular or Thoracic surgeon. Some Docs will do more like Dr. Thompson. Some do Pec Minor Tenomotys. If you have a cervical rib they will (or should) take that out if it is the cause.

Since it is so hard to figure out where the problem is and in some cases multiple issues, I beleive Ideally, the best Docs will determine what exactly the problem is and do the surgery accordingly. This seems very hard to find-Dr. Donohue in Boston seems to be one-poss Thompson and Pearl.

This is just my opinion.In my case, I realized thru PT that my ribs were causing many of the problems. Once I got my ribs back in place-my scalenes and pec minor got better. I still have to do mobilizations and stretches to keep it in check. My Trapezious muscles are still tight as rocks and I still get nerve flares in my neck and Traps, but that my be more related to a bulging disk and bone spurs. this complicates matters and is what is called double crush syndrome.

Good Luck.
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Old 07-30-2013, 01:41 PM #8
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In my research, some neurosurgeons do scalenectomy only.

The history on this is surgeons only did one or the other until the early 90s. Dr. Atasoy (who I think just retired at the age of 80 something) was the first to do both at the same time and the better surgeons have learned to do both over the last 15 years. I actually saw Atasoy and he was the first to diagnose me positive TOS. He offered to do scalenectomy and not rib. I did not understand why so I dug into it a bit and found out he could no longer do both. His nurse actually told me this. I was already looking for a surgeon who was younger but this really sealed it for me to find a younger surgeon. However I do think Atasoy was a pioneer and one of the most knowledgeable in the world of TOS.

I had scalenes and rib removed and I am actually regretting the scalenes. I may be unfairly blaming it on the scalene part of the surgery but it tore my neck up and it feels permanent. I had three previous surgeries on the cervical spine and I think this was just too much in one area and now I have severe scar tissue.

We are all different though. If a doctor can confirm scalenes as the problem it would be an easier operation than the rib.
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Old 07-31-2013, 06:48 PM #9
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Thanks for all the replies.
The scalene block was very succesful and the doctors have not been able to find and other obstructions. Muscle relaxers also help a lot with the pain. That is why I am considering the scalenectomy. I was hoping to hear about positive results.
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Old 08-10-2013, 10:31 AM #10
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I believe stos2 had scalenectomies quite a while ago with positive results. Symptoms returned after she stopped her maintenance therapy/exercise but got things back on track.
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