As a result of the devastating insults sustained secondary to the presence of the 7th cervical rib and her subclavian artery occlusion, this patient faced months of recovery.
Management of cervical ribs and anomalous first ribs causing neurogenic thoracic outlet syndrome.
If symptoms recurred, a first rib resection, with or without thrombectomy, was considered, as well as resection of the scalenus anticus muscle and removal of any other compressive element in the thoracic outlet, such as the costoclavicular ligament, cervical rib, or abnormal bands (55).
They were separated into the following etiologies: mistaken resection of the second rib instead of the first (22 patients), resection of the first rib with a cervical rib left in place (11 patients), resection of a cervical rib with an abnormal first rib remaining (8 patients), and resection of a second rib with a rudimentary first rib left (2 patients).
Patients with compression from the first or cervical rib producing aneurysm with or without thrombus should undergo rib resection and aneurysm excision with graft using the supraclavicular and infraclavicular combined approach.
An experimental study of circumscribed dilation of an artery immediately distal to a partially occluding band, and its bearing on the dilation of the subclavian artery observed in certain cases of cervical rib.
Costoclavicular compression associated with cervical rib.
In the presence of cervical rib, the subclavian vessels and brachial plexus have been classically described as always arching over it.
In our patient, it is probable that the right subclavian artery was superiorly displaced into the surgical field by a combination of the cervical rib and the neck extension.
Thoracic outlet syndrome with arm ischemia as a complication of cervical rib.
An anteroposterior radiograph of the cervical region revealed a right cervical rib and a pneumatocyst of the proximal epiphysis (Fig.
11) When evaluating a patient with neurologic symptoms, the presence of a cervical rib and associated thoracic outlet syndrome should be investigated.
The cervical rib is a supernumerary rib arising from a cervical vertebra or elongated transverse process of the 7th cervical vertebra articulated to the first rib or ended freely.
To the best of our knowledge, this is the only case demonstrating a pneumatocyst of a cervical rib in association with KFS.
Pneumatization of a cervical rib, as far as we know, was not reported before solely or in association with Klippel-Feil syndrome; therefore, our case may have coincidental findings and the confirmation of any association requires new additional cases.