A Never Described Variant of the Cervical Rib Causing Arterial Thoracic Outlet Syndrome: World's First Case

Abstract

Cervical ribs, also known as Eve's ribs, are rare and found in 1% of population. They are more common in females and more common on right side. They are asymptomatic in 90% of cases. Cervical rib fused with transverse process of sixth vertebra is rarer. We present a case of dry gangrene of lateral three fingers with right radial and subclavian artery thrombosis with rest pain, due to right cervical rib fused with transverse process of sixth vertebra. After development of line of demarcation of the dry gangrene, patient was operated for excision of cervical rib and sixth cervical vertebral transverse process followed by Ray's amputation of right second finger. Postoperative course was uneventful. Patient was discharged with oral anticoagulation and a healthy wound in right hand.

Accessory articulation of the transverse processes in the cervical spine

“…It also is a site of origination and insertion for the longus colli, anterior scalene, and longus capitis muscles [ 11 , 12 ]. The C7 anterior tubercle provides a site of attachment for the suprapleural membrane of Sibson and also for the scalenus pleuraris muscle and cervical rib, both of which are anatomic variants [ 13 , 14 ].…”