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Excision of Cervical Rib

  • Posted on- Apr 09, 2018
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Human ribs are curved bones that help to protect the heart and lungs. There are 12 pairs of ribs altogether. Together, these 12 pairs of ribs form the human rib cage.

At the back, the head of each rib makes contact with (articulates) one of the thoracic vertebrae. The vertebrae are backbones. The thoracic vertebrae are the vertebrae in one's chest area (thorax). There are twelve thoracic vertebrae. The cervical vertebrae are the vertebrae in one's neck. There are seven cervical vertebrae.

What is a cervical rib?

About 2 in 300 people are born with an extra rib called a cervical rib. Because this is something that one is born with, it is known as a congenital condition

At the back, this rib connects to the seventh cervical vertebra in one's neck. At the front, in some people a cervical rib can be 'floating' and have no connection.

In other people, it can be connected to one's first rib by a band of tough, fibrous tissue. In some others, there may be an articulation (like in a joint) with their first rib.

A cervical rib can be present just on the right side, just on the left side, or on both sides.

What is the cervical rib?

The cervical rib is a space, or passageway, that lies just above one's first rib and behind the collarbone (clavicle). There are also some muscles that surround the cervical rib. The thoracic outlet runs from the base of one's neck to his armpit. You have a cervical rib on the left and the right side of your body.

A number of structures pass through your cervical rib, including some important blood vessels and nerves. The brachial plexus, a group of nerves passing from your neck to your arm, passes through the cervical rib. The subclavian artery and subclavian vein are blood vessels that pass through the cervical rib as they connect between your chest and your arm.

Having a cervical rib

About 2 in 15 people who have a cervical rib develop thoracic outlet syndrome. Thus, most people with a cervical rib do not develop any symptoms. Having a cervical rib can cause narrowing of your thoracic outlet, making compression of the structures that pass through it more likely.

How is cervical rib disorder diagnosed?

A chest X-ray and X-ray of your neck can show if you have a cervical rib. Other tests including an MRI scan or CT scan of your neck and upper chest area may help to rule out other causes for your symptoms.

For example, arthritis in your neck may be causing compression of the nerves in your neck. Special tests called nerve conduction studies may sometimes be suggested. These look at the electrical activity of your nerves and can help to show which nerves are being compressed.

If your doctor suspects that you have compression of your subclavian artery or vein, other tests may be carried out to look for this. A test called angiography deals with your arteries and venography deals with your veins. Special tests known as Doppler studies can also look at blood flow through your arteries and veins.

What is the outlook (prognosis) for cervical rib disorder?

In most people with cervical rib disorder, the outlook is generally good and symptoms often improve over time.

If squashing (compression) or blockage of the subclavian artery or vein is diagnosed quickly and treated, a good recovery is possible. However, nerve compression symptoms can be difficult to treat in a few people.

Persistent (chronic) pain and weakness with some loss of ability to use the affected arm may be experienced by some. This can sometimes be severe enough to affect the quality of life.


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