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Why Cervical Ribs (Extra Ribs) are Most Likely NOT the Cause of Your Thoracic Outlet Syndrome

Cervical Ribs are Conditions You Are Born with or Anomalies
(Cervical Ribs, Elongated Bones)

Cervical ribs are an extra set of ribs at the top of the rib cage. There can also be partial ribs or elongated prominences, called thoracic processes, that doctors think can compress the outlet.
It is rare for patients with an extra rib to spontaneously develop thoracic outlet syndrome. Cervical ribs are rare. The incidence of cervical ribs has been found to vary from 0.58 percent in the Malaysian population to 6.2 percent in the Turkish population (18). The incidence of cervical ribs has been estimated at 2 percent (19), with one expert quoting the incidence to be less than 1 percent, of the population in the United States (20).

I have been in practice for 30 years and have not seen one case where an extra or deformed rib was the cause of thoracic outlet syndrome. This is a congenital anomaly that is something you are born with, that usually compensates to allow your thoracic outlet and tunnel to have a normal amount of space for nerves and blood vessels to pass. Remember, the spring suspension system supported by muscles is what maintains the integrity of the thoracic outlet and tunnel.

However, when doctors who are unfamiliar with the true spring design see these extra ribs on X-rays, oftentimes they just make a snap judgment that they are the cause of the compression and advise the patient to have them removed. When patients see them, they are oftentimes in shock and right away think they should be removed too.
Here is where logic steps in. If you are 30 years old and just started to have symptoms of thoracic outlet syndrome, get an X-ray, and see your cervical ribs, they are NOT the cause of the compression of the outlet. The size and shape of those ribs matured by your 21st birthday and for many of you by your 18th birthday. Extra ribs cannot be the cause of compression of the outlet in this case.

Many patients have congenital anomalies, such as scoliosis, extra ribs, extra lower back or neck vertebrae, and even fused vertebrae. They are interesting, but they rarely, if ever, cause any problems. I know many top athletes and even power lifters who broke world strength records with severe scoliosis, extra and fused vertebrae. These normal variances are just there to throw doctors off when they don’t know their stuff.

However, scoliosis curves and deformities can get so bad before the age of 18 that they can require surgery to correct them. Surgery for adolescents with scoliosis is only recommended when their curves are greater than 40–45 degrees and continuing to progress, and for most patients with curves that are greater than 50 degrees.

My father was the chair of the Shriners Hospitals Committee for Crippled Children. To this day, he is the number-one sponsor of children into Shriners Hospitals. I am not against surgery that is medically necessary.

I just haven’t had one case of TOS I thought could not be reversed with my logical nonsurgical approach.

If you have thoracic outlet syndrome and scoliosis or a cervical rib and the doctors want to operate on you claiming the thoracic outlet syndrome is caused by your cervical rib… please make an appointment for a free strategy meeting so we can talk this out before you make a painful mistake.

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