@mlerin You are most welcome. I'm glad to help. @ken82 also makes a good point in that you can have pain caused in a peripheral area of the nerves. Pain can be generated from anywhere along the path of the nerve or in multiple places and it feels the same as pain generated from compression at the spinal nerve roots in the foramen. This is what the neurologists test for to try to figure out the point of compression based on how fast the nerves conduct electricity, and how well a muscle responds when it receives that electrical impulse or not. For me, thoracic outlet syndrome generates pain where the nerve bundle passes through the areas of the scalene muscles on the side of the neck, in between the collar bone and rib cage, and under the pectoralis minor muscle where it attaches to the arm pit. Spine surgery doesn't fix those compression points, and I work on those in physical therapy. Those areas became more painful after spine surgery for a bit because everything tightened up with the scar tissue and healing. I had to wait for the fusion process to begin before I could do any stretching and PT in those areas of my neck. The surgical incision is very close to the areas with the TOS issues, and after I could rehab and strengthen my neck (gets weak in a neck brace after 3 months), I am making progress again with myofascial release of the tight areas. I had spine surgery without hardware, and only have a bone graft, so I had to be careful not to do anything that could dislodge it and lived in my neck brace. My surgical notes say that the surgeon tested it in the OR and it didn't move when he tugged on it. The surgical incision was closed in layers with dissolving sutures very neatly by the neurosurgical assistants and the scar is hardly visible in the crease in my neck.

Here are a lot of links to information about my Mayo neurosurgeon, Dr. Jeremy Fogelson in Rochester. He is a gifted surgeon and a very kind and compassionate man and who loves his job. It would be worth the trip to get an opinion at Mayo. I tried for 2 years to get help and was refused by 5 local spine surgeons where I live likely because my symptoms were unusual, and the care and efficiency that I experienced at Mayo was far superior to anything else. I didn't know medicine could be that efficient and that I would have expert care and have all the testing done in 2 days, and that I would have an answer at my first appointment with the surgeon, and that surgeon would be a very nice guy. When you are the patient who is worried, compassion and understanding from your surgeon helps a lot. Those 2 years before I came to Mayo were always a wait for appointments and testing, and waiting again to follow up and it drug on as my symptoms got worse. I had documented the changes as it progressed, and I was loosing my shoulder and arm muscles to atrophy from my spine problem, and even when I brought that up, I was told it didn't look bad, but that local surgeon didn't know what was normal for me, and didn't listen.

Good luck in your quest. For me, this was life changing and coming to Mayo gave me back the ability to reclaim my talent and do my artwork. Let me know if I can answer any questions.

https://www.mayoclinic.org/biographies/fogelson-jeremy-l-m-d/bio-20055624
https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/
https://sharing.mayoclinic.org/2012/12/23/repaying-a-gift-scholarship-recipient-says-thanks-in-a-special-way/?utm_campaign=search
https://sharing.mayoclinic.org/2017/07/26/spinal-surgery-saves-teen-swimmers-mobility/?utm_campaign=search
http://www.startribune.com/in-second-term-minnesota-gov-markdayton-dealing-with-more-health-problems/361662931/
http://www.startribune.com/gov-mark-dayton-to-undergo-third-back-surgery/497015811/
https://www.mayoclinic.org/medical-professionals/trauma/news/geriatric-winter-falls-when-a-simple-bump-on-the-ice-can-be-serious/mac-20451017@