Incidence and Clinical Implications of Cervical Rib: A Retrospective Study

Abstract

Introduction: Cervical ribs are an additional rib, which arise from the costal element of the seventh cervical vertebra. Incidence varies from 0.58-6.2%, incidentally detected on radiographs, but when enlarged can lead to various vascular and neurological symptoms. When it is of sufficient length it can compress the neurovascular bundle leading to Thoracic Outlet Syndrome (TOS) causing vascular and neurological symptoms. Aim: To determine the incidence and morphology of cervical rib in a convenient sample. Materials and Methods: A retrospective observational study was done in 650 radiographs (356 males and 294 females) from January 2016 to January 2019 and the study was conducted at ESIC Medical College and PGIMSR, Chennai, Tamil Nadu, India, and the data was analysed for the incidence and morphology of cervical ribs. Results: Incidence of cervical ribs in females (1.7%) was higher than males (1.12%). In the present study, incidence of cervical ribs was 1.38%, we observed there were seven cases of bilateral cervical ribs and two cases of unilateral cervical rib. Morphologically, cervical ribs had head, neck and tubercle and articulated posteriorly with transverse process and no other significant morphological variations were seen. Conclusion: Knowledge regarding incidence of cervical ribs and other rib anamolies assists the radiologist and surgeons in early diagnosis and management of symptomatic patients in order to avoid neurovascular complications.

Keywords

• chest x-ray
• neurovascular compression
• seventh cervical vertebra
• thoracic outlet syndrome