ADVICE on surgery for thoracic outlet syndrome?

I would like to know if anyone has ever had surgery for TOS? If so, was it worth it? What were the proceedures?

IF not, does anyone know what they do during surgery for a Vascular T.O.S?

General info: I dont have an extra rib, its vascular which is affecting the subclavian artery.

The Doctor suggested that Physical Therapy isnt an option. Should I get a second opinion?

Yes, if your TOS is vascular in nature, then your doctor is correct, physical therapy will not help (unless it is a musculoskeletal reson why the subclavian artery is have problems...such as tight muscles). What you describe sounds like there is some type of obstruction to the subclavian artery...if they is the case, I imagine that they may look into angioplasty or stenting.

I've only had patients who've had the surgery for a cervical rib removal (usually because they need therapy for stretching afterwards)...but I imagine that if it is vascular in nature, this will not be the case and I'm surprise this isn't being done as an urgent surgery...but yes, I would get a second opinion from a vascular surgeon.

Hi,
For TOS, the conventional treatment recommended is physiotherapy. Surgery is the last resort in cases with no relief and in whom there are complications. Various studies have shown that in uncomplicated TOS, the recovery is better with non-surgical treatment than with surgical treatment. The surgery done for TOS is decompression by removing the extra rib or the first rib (this will be the option in your case, since you donot have an extra rib). Also, in some cases, there is damage to the the arteries due to longstanding compression. In such cases, a repair of the artery also needs to be done. Since it is a high risk surgery, I would advise you to get a second opinion before going in for the procedure/surgery.
Regards,
Dr. Gupta