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.

I just had a rib resection, pec minor release, and basically a scalene release. I thought that they would remove the scalennes completely, but in my case they just detached them from the bottom as they removed the rib. The muscles shrunk back about an inch.

Hi u mite want to look in the new TOS medical text book just released in may '13. Should be some info. about throw 2 different surgeries. There's a link on this site n u can find it on amazon too. Ask? ? to get all the facts! I didn't even know there was a surgery called Scalenotomy. Is this when they just take part of the muscle? I had Scalenectomy of the Anterior Scalene (all the muscle was removed) and half of the Middle Scalene removed Bc this muscle goes way up the neck, is what my Dr said. I think if the space looks like the artery or vein is being compressed on Ct scan they will remove the 1st rib too.
What I dont understand about that study is if the 1strib & muscle is removed, how could the muscle reattach itself to the rib? It doesn't make sense! I would look at newer studies there are a lot on pudmed.
Where are u having ur surgery?
Best of Luck to u!

Hi- I'm having the surgery on 23rd of October at UCSD.
Dr. Brown has done a lot of theses surgeries and he said he has even seen an artery sitting on top of the brachial plexus, causing all the pain. I had a positive scalene block and I was in a car accident when I was in my 20s (with severe whiplash).
Fingers crossed...