August 2016

24 year old female with symptoms of Thoracic Outlet Syndrome (TOS). The symptoms for TOS include but are not limited to pain, loss of sensation, and muscle weakness in both arms and shoulders. This patient also has a history of thoracolumbar scoliosis with spinal stabilization hardware. There are many causes and conditions which may be attributed to TOS, but for this presentation we will focus on the anatomical variant cervical ribs.

3D reconstructions of a computed tomography examination (images A and B) demonstrate bilateral cervical ribs (left- red arrow and right – green arrow). Cervical ribs are a congenital abnormality where an extra rib arises from the seventh vertebra and is located above the first rib. Cervical ribs can sometimes squash or compress one of the nearby blood vessels or nerves which results in the symptoms attributed to TOS.

Subsequently, the patient had both cervical ribs surgically removed. Image C is a chest radiograph demonstrating the surgical removal of both cervical ribs. Stanford 3DQ Lab technologists generate these images utilizing specialized 3D software tools. The images that the 3DQ Lab provides displays the pathology and anatomy which guides the surgeons prior to treating patients.