Scalene Test Blocks and Interventional Techniques in Patients with TOS

For targeted therapy such as TOS surgery to be effective, it must be determined that a particular patient has a disability actually caused by TOS and that this component overshadows any coexisting causes of disability. When the TOS component of a cervicobrachial syndrome is temporarily reversed with selective blockade it is expected that the longer term benefits of a targeted approach may be predicted. The present chapter will discuss the evolution and implementation of scalene test blocks in performing the role of predicting outcomes to TOS targeted therapy. For those patients who are not TOS surgical candidates other pain interventional techniques are discussed.