Cervical rib, case series from a university hospital of Nepal

Abstract

Cervical rib is a rare anatomical anomaly with an incidence of 0.2%–1% and is an important cause of thoracic outlet syndrome. We present a case series of five female patients with a mean age of 20.6 (15–26) years, symptoms present were neck pain, neck mass, tingling sensation and weakness in the affected side. Symptoms develop in adolescence probably due to sagging of the shoulders and a disproportion between chest and neck growth at this age. X-rays of cervical spine was a common mode of diagnosis and showed bilateral cervical rib in three cases and unilateral in two cases. They were managed by performing surgeries under supraclavicular approach with resection of cervical rib of affected side. There was improvement of symptoms with restoration of limb function with a mean time of recovery of 9 weeks. Early diagnosis is important as differential diagnosis of such symptoms may be cervical stenosis and myelopathy which differ in management and have a greater risk of morbidity. In absence of intervention, cervical ribs can lead to compression of neurovascular structures leading to worsening of symptoms, thrombosis of subclavian artery or cerebral emboli.

Transaxillary Approach for Thoracic Outlet Syndrome Case Report

“…Hox gene mutations are to blame for the emergence of cervical ribs (9). Galen and Vesalius provided a detailed description of the cervical rib for the first time (10).Although cervical ribs are often located on the left side of the body, the right side is utilized more frequently; hence the symptom first appeared there (10,11). The left side likewise showed signs of development earlier in our case study.…”

Incidental Discovery of a Cervical Rib in a Case of Acute Cholecystitis: A Rare Anatomical Variant

“…Yadav et al provided a series of cases from a Nepalese University Hospital that clarifies cervical ribs' therapy and clinical presentation, mainly concentrating on a younger group with a 20-year average age [ 5 ]. Interestingly, the acute stomach symptoms our patient experienced are not the same as those listed in their series, which include neck discomfort, mass in the neck, tingling sensation, and weakness on the afflicted side.…”

“…The left side of the body is more likely than the right to have unilateral cervical ribs [ 4 ]. Compared to bilateral cervical ribs, unilateral cervical ribs are more common [ 2 , 5 ].…”

“…Cervical ribs, variations of rib-like structures originating from the cervical vertebrae, are categorized into four types based on their distinct characteristics. Type 1 cervical ribs are fully formed ribs that typically connect to either the first rib or the manubrium, a part of the sternum [ 1 , 5 ]. Type 2 cervical ribs are incomplete, lacking a full connection, and often have a free distal tip [ 3 ].…”

Effects of bacterial biofilm on regulation of neurovascular unit functions and neuroinflammation of patients with ischemic cerebral stroke by immunocyte

“…At present, it is generally believed that vascular neural units play a significant role in the occurrence and development of ischemic cerebral stroke and the reconstruction of peripheral vascular tissues after stroke. After the proposal of the relevant concept of neurovascular units, the cause of the failure of focusing solely on neurons and ignoring vascular injury and other neuroprotective interventions becomes much clearer (5). Neurovascular units have a remarkable effect on the interaction between neurons around cortical capillaries and vascular cells.…”