Quick background:

NTOS and had Scalenectomy in May 2012 (No rib removal and no total scalene removal)

Dx'd with Brachial Neuritis a month ago and have been in pain for about 2 to 3 months, severe pain for about 3 days about 6 weeks ago

Currently taking Lyrica and Robaxin for the pain, had a cervical esi pain block 2 weeks ago.

My surgeon isn't discussing a 2nd surgery with me and sent me to pain management. Does anyone have any advice as to where to go from here? I'd like to know if I could benefit from a 2nd surgery with scalene removal and rib resection. Pain management has talked about SCS implant if meds don't work. I plan on giving this another couple of months before making any big decisions...

Do you feel your surgeon was highly rated , skilled & current on TOS issues?

Was there any specific reason for (No rib removal and no total scalene removal)?

But then again NTOS is very tricky even for top TOS surgeons.. sometimes surgery just isn’t much help.. may reduce some sx & pain, but not all.
internal scarring/scar tissue is another issue that may come into play ...

Questions..
avg pain levels in a day?
bilateral? L or R ?
What are your most bothersome symptoms/pain?
any expert PT/therapies?
any alternative - acupuncture, massage, low level laser, electric stim/TENS etc?

explore all of our sticky threads , holidays often make for fewer members online...
http://neurotalk.psychcentral.com/thread84.html
http://neurotalk.psychcentral.com/thread135.html

The surgeon was Dr Richard Meyer in Birmingham, AL. He's part of the UAB system which is well respected in the Southeast. He performs multiple TOS surgeries yearly, I'm not sure about the average.

It was only the release, no rib or total removal. He stated that he performed conservatively at the time and now does the rib removal for all. Less repeat issues for patients.

Average pain a day post op was prob a 2 or 3 until I was diagnosed with Brachial Nueritis. The new issue has stopped me in my tracks, if I get up and move for about 20 to 30 mins I feel burning nerve pain above my collarbone. TOS is on my right side.

No expert PT in my area, I went through strengthening exercises in PT post op. Message therapy has helped and had electric stim in PT. Helped some.

Would someone like me benefit from a total scalenectomy? And why would some surgeons perform the total removal vs only the release? My surgeon only cut out scar tissue.

And how often do post op TOS patients experience Brachial Nueritis years later? I've never heard of anyone else experiencing it.

Thanks for responding...

You probably did a search to compare BN vs TOS already.
but I'll add the results link for future readers too -
https://www.google.com/search?q=Brac...utlet+syndrome

One link I read is the neuritis may fade away but may take 2-3 yrs...

I would get a second opinion by another top surgeon if possible..
this is your life and sticking with the same surgeon only- might leave you open to another or better options being missed completely.

Post op your pain level was only 2-3 ? was that with meds or no meds?

Usually most here will suggest to consider surgery as last resort , like extremely high pain, if clots are major factor, or a extra rib or bony issue..

I would really suggest seeing a top TOS surgeon for second opinion...to get the very best of care..especially since it may be a second go around.. not a time to take chances or jump into another surgery.

Right, I believe I'm out of the worst/acute stage of BN, I'm experiencing pain when moving around after about 30 mins and some weakness. From what I understand and like you said, most people recover in a year or 2.

Yes, pain was a 2 or 3 on most days after I completed PT. No meds. Some bad days here and there of course. Only thing I really avoided was heavy lifting with my right arm.

The reason I'm wondering about a redo is because I've been out on FMLA for 2 months now, I have 2 small children and I want to continue to work. Of course I'm going to wait and see if the BN fades before doing anything drastic. Also, for about 9 months leading up to the BN and since my scalenes have been in a constant state of spasm. Hence the Lyrica and Robaxin meds now. I have family in the St. Louis area and I've thought about contacting Thompson. He does the total scalenectomy which is what I've got questions about. Chris Young's story is crazy to me, he won comeback player of the year after his surgery.

“We did an approach from above the clavicle to remove the first rib and the two scalene muscles that attached to it,” says Dr. Thompson. “We found scar tissue that had formed around the brachial plexus nerves and we removed the scar tissue and mobilized each of the brachial plexus nerves. Through a small second incision below the collarbone, we released the tendon of the pectoralis minor muscle, as well. And so we opened up the space all the way through the thoracic outlet for the brachial plexus nerves.”

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Jo*mar, sorry about posting that partial link, I didn't know that was against your guidelines.

With all of the posting I've done, here are my main questions if anyone can help:

1. Has anyone else developed Brachial Nueritis post surgery?

2. Why do some surgeons perform total scalene removal vs the scalene release (scar tissue removal only)?

3. Has anyone who had surgery developed issues with continuous muscle spasms in their neck years later? I believe it's my anterior scalene that is hard as a rock. Like I said earlier, currently on Robaxin and Lyrica for this.

You can also use our search tool to find any past posts on those topics you are asking about.
That may bring up members & post with similar issues.
http://neurotalk.psychcentral.com/search.php