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At least 19 recordsLinked to original sources
PubMed1998

[The importance of excision of the first thoracic rib and accessory cervical rib in the treatment of deep venous thrombosis of the upper extremities].

This paper presents 15 cases of deep venous thrombosis of the upper extremity as a complication of previously asymptomatic thoracic outlet syndrome. The diagnosis was based on clinical examination and phlebography. To achieve prompt recanalisation of the vein streptokinase was used. Fibrinolytic treatment was followed by surgical treatment carried out 6 to 8 weeks after resolution of acute symptoms. The surgery consisted of excision of first rib and accessory cervical rib when present through the axillary approach. In 73% of cases complete lysis of the thrombus was achieved which was confirmed by phlebography and resolution of symptoms of venous hypertension.

Acute Disease↗
PubMed1980

The vascular complications of cervical rib.

The consequences of cervical rib do not appear to be widely understood. Whilst most cervical ribs cause little or no trouble, and, at the most, require shoulder raising exercises, some are the cause of serious nerve compression and sometimes arterial compression. Much confusion has existed in the understanding of the vascular manifestations of cervical rib, and this confusion has often led to incorrect treatment with serious consequences. In this regard it is particularly important for the surgeon to deal with the diseased artery at the same time as the cervical rib is excised. Nine cases of cervical rib with arterial compression are reported. The importance of recognition of arterial compression, before surgery is undertaken, is stressed.

Adult↗
PubMed2003

Tracheostomy in patients with cervical rib: a note of caution.

Cervical rib is a congenital phenomenon that usually occurs in association with upper-limb neurovascular symptoms. The presence of a cervical rib displaces the great vessels that cross the thoracic outlet superiorly and proceed into the neck. We report an unusual case of iatrogenic hemorrhage during a tracheostomy in a patient whose right subclavian artery had been displaced by a cervical rib. Our aim is to alert surgeons to the hidden risks of this phenomenon.

Aged↗
PubMed2002

The association between cervical rib and sacralization.

STUDY DESIGN: After determining the normal reference values for the length of the transverse processes of the seventh cervical vertebra, the association between the presence of cervical rib and sacralization was investigated. OBJECTIVE: To determine the length of cervical rib and search for any association between cervical rib and sacralization. SUMMARY OF BACKGROUND DATA: Both cervical ribs and sacralization have been noted in some patients in the authors' clinical practice. METHODS: The cervical rib is a supernumerary rib arising from a cervical vertebra, or it might be simply an elongation of the transverse process of the seventh cervical vertebra. However, there is no consensus about a specified length of this process. For reference values, anteroposterior cervical radiographs of 210 normal individuals (112 male, 98 female, mean age 33.9 +/- 10.1 years, range 19-61 years) were taken, and elongation of the transverse processes beyond 2 standard deviations (30 mm) was considered as cervical rib. In the guide of the reference values, 324 outpatients (165 male, 159 female, mean age 42.0 +/- 14.6 years, range 17-85 years), having cervical ribs or sacralization detected by plain radiographs, were taken as the study group. As control 729 volunteers (364 male, 365 female, mean age 41.7 +/- 14.3 years, range 15-76 years) were studied. RESULTS: In 1053 patients, of 471 patients having cervical ribs, 345 (73.2%) had also sacralization; of 536 patients with sacralization, 345 (64.4%) also had cervical ribs. Significant associations were found between cervical rib with or without articulation and sacralization [chi2 = 52.284, P < 0.001, odds ratio 5.097 (3.156-8.234); chi2 = 139.473, P < 0.001, odds ratio 5.204 (3.922-6.905), respectively]. CONCLUSION: Presence of cervical rib might be a clue to the existence of sacralization or vice versa. In patients with cervical or lumbar pain, this association may be helpful for differential diagnosis before applying sophisticated diagnostic techniques.

Adolescent↗
PubMedDate not supplied

Cervical ribs: useful marker of monosomy X in fetal hydrops.

Cervical ribs were observed in six hydropic fetuses with 45X karyotype. To test the usefulness of this observation in the macerated hydropic fetus where chromosome culture is problematic, a group of 36 hydropic fetuses was examined. Cases were chosen to include fetuses with several karyotypic and pathological abnormalities known to be associated with fetal hydrops. Whole-body anteroposterior radiographs were evaluated without knowledge of the fetal karyotype or pathological findings. Twenty-five fetuses had an abnormal karyotype, seven had a normal karyotype and in four culture failed. In the last group, the number of X, 21 and 18 chromosomes per nucleus was estimated using FISH. Radiographic analysis demonstrated that among the 16 fetuses with 45,X karyotype or a single copy of X and female phenotype, 12 had a pair of cervical ribs. Three other fetuses had a single cervical rib. Only one fetus had no cervical ribs. The last fetus had tubular hypoplasia of the aortic arch and persistent mesocolon. Twelve of the sixteen 45,X fetuses had tubular hypoplasia of the aortic arch. Seven had other cardiovascular anomalies, five had renal anomalies, and five had anomalies of intestinal rotation. Cervical rib appears to be more common than other frequently recorded associations of 45,X. It is a useful and easily demonstrated mark in the evaluation of the macerated hydropic fetus.

Female↗
PubMedDate not supplied

The subclavian artery in 16 patients with complete cervical ribs.

In a series of 16 patients presenting with symptoms due to the presence of a complete cervical rib, 8 complained of neurological symptoms only and 8 presented with major vascular symptoms. There were 21 complete cervical ribs in this series, 5 patients having bilateral cervical ribs, and these were excised. At operation particular attention was paid to the anatomy and pathology of the subclavian artery in relation to the cervical rib. Two anatomical variants were present. In type A cervical rib (16 cases) the subclavian artery crossed the first rib medial to the exostosis and all patients with major vascular symptoms were in this category. In type B (5 cases) the subclavian artery crossed the first rib lateral to the exostosis and symptoms, when present, were neurological rather than vascular. The two groups can be distingushed clinically and this may be of prognostic value. Post-stenotic dilatation of the subclavian artery acompanied 15 of the 21 complete cervical ribs and was attributed to compression of the artery between the cervical rib and the anterior scalene muscle. In 8 instances the post-stenotic dilatation was complicated by aneurysm and peripheral thrombo-embolism and this was regarded as a secondary phenomenon due to intermittent trauma at cost-clavicular level. A follow-up of up to 9 years would indicate that post-stenotic dilatation of mild or moderate degree is adequately treated by resection of the cervical rib and exostosis on first rib. When an aneurysm is present with localised disruption of the arterial wall with mural thrombus, it is necessary also to excise the aneurysm for, otherwise, there is a risk of further thrombo-embolic episodes.

Adult↗
PubMed2003

Management of cervical ribs causing neurogenic thoracic outlet syndrome: a ten year experience in the neurosurgery unit, Tikur Anbessa Hospital.

Eighteen cases of cervical Ribs causing numbness, paraesthesia and wasting of hand muscles were seen during the years 1990 to 1999 in neurosurgery unit of Tikur Anbessa, a central, referral teaching hospital. There were thirteen cases of unilateral, and 5 bilateral brachialgic pains M:F = 1:2 with ages range from 15-50 yrs (mean age 32 +/- 4.8 yrs); though it is 3 times common in women specially those with neurologic symptoms. 5 cases didn't have any cervical ribs. All had respective cervical rib resections and scalenotomy done. Paraesthesia and pain were relieved in about 90% of the cases. Cervical rib causing Thoracic Outlet Syndrome (TOS) is a rare condition commonly seen in less than 1% of the population as seen here in 18 cases in 10 years period. The absence of cervical rib doesn't rule out thoracic outlet syndrome as it can be from anomalous first ribs, scalenus anticus syndrome or congenital fibromuscular bands. Surgical excision has a good neurological outcome. No subclavian vessel especially arterial compression cases were seen in this study as cervical ribs can cause neurovascular compression. The diagnostic and therapeutic measures are clearly stated as this syndrome is a diagnostic and treatment challenge to the practicing general surgeons. Accurate diagnosis and proper surgical intervention are very crucial for the good outcome.

Adolescent↗
PubMed1988

Results of excision of a cervical rib in patients with the thoracic outlet syndrome.

Excision of a cervical rib in patients with the thoracic outlet syndrome has been the subject of debate. One surgeon's experience of 23 cervical rib excisions is presented. Ten operations produced a complete cure, eleven improvement, and two no change in the patient's condition. Of 15 cases with neurological symptoms alone, 9 were cured, 5 improved and 1 was not helped; in contrast, of 8 patients with vascular symptoms, 1 was cured, 6 were improved and 1 was not helped. We conclude that cervical rib resection is the correct treatment for patients whose symptoms are predominantly neurological. Rib resection alone may not be sufficient in patients with vascular symptoms. The management of a cervical rib with vascular involvement is discussed.

Adult↗
PubMedDate not supplied

Lower trunk brachial plexus compression neuropathy due to cervical rib in young athletes.

Compression by a cervical rib may result in neurologic and/or vascular symptoms. Two patients are reported with thoracic outlet syndrome (TOS) secondary to cervical rib. Both patients had vague shoulder pain as well as neurologic manifestations due to compression neuropathy of the lower trunk of the brachial plexus. One patient was suspected initially to have carpal tunnel syndrome.

Adolescent↗
PubMedDate not supplied

Cervical rib syndrome: a neurosurgical experience with a series of 38 cases.

A series of 38 patients with thoracic outlet syndrome caused by a cervical rib is reviewed after a postoperative follow-up period of 3 to 24 years. The outcome of the operation (anterior scalenotomy and partial to subtotal removal of the cervical rib) is not considered wholly satisfactory; three causes for this were identified: excessive duration of symptoms (mean almost 6 years), insufficient patient work-up and inadequacy of the incomplete removal of the cervical rib. In the presence of a cervical rib, other possible causes of compression of the neurovascular supply to the upper limb should always be considered.

Adolescent↗