Cervical ribs and NTOS

Abstract

Bone abnormalities of the C7 vertebrae include cervical ribs and elongated transverse processes, and represent space-occupying lesions within the confines of the thoracic outlet. These bone abnormalities, or the fibromuscular attachments between them and the underlying first thoracic rib, may cause irritation to the brachial plexus producing symptoms of NTOS. Conservative treatment may be the initial management, but is effective in a minority of patients. Surgical decompression of the thoracic outlet results in symptomatic improvement in most patients.