United Brachial Plexus Network, Inc.

I went to my PT today for the 1st time and she told me something very interesting. Oddly enough even though I had the information all along, I never realized I have an extra portion of a rib at C7. She told me that most of the BPI's she's seen have an extra rib.

I have to wonder what came first...the chicken or the egg.

Is there a chance we were more likely to be injured at birth because of this extra rib? My theory right now makes me wonder if we don't fold up as compact as we should if there's an extra rib. Maybe that's why we get stuck whether we're big babies, average babies or small babies. Just something to contemplate, at least in my curious head.

She also wonders if my hand isn't so much Trigger Finger as it is a compression from the extra nerve.

Is any of this crazy talk or does it make sense?

-Traci

Traci,
This ISvery interesting to me too. I too, wonder...
but we can never know for sure unless somebody does a complete Research Study on all of us adults 20 and older. !!

Anybody in Medicine "listening"??!!--GRrrr

Carolyn J
LOBPI/ age 70--sometimes crabby

This gets into a touchy area, as so many OB/GYNs and their defense lawyers have tried to capitalize on "alternate causes" to deflect their own responsibility completely, which is abhorent.

HOWEVER, that said, I do think there is ample evidence to suggest that predisposing factors play a major role in whether a brachial plexus injury occurs under specific birthing (and external traction) circumstances, or affects how bad the resulting injury is. An additional cervical rib is one of these factors, but there are surely many more, such as intrauterine positioning, lack of amniotic fluid, etc. I doubt any of these can be proven to CAUSE injury, but they may make injury more likely for those infants over others subject to the same forces. I've seen videos where the traction applied is SO MUCH MORE than what Joshua received, and yet he was injured and that child was not.

I think this also really complicates the challenge of changing doctors' treatment of birth and use of traction. All OB/GYNs, by the time they reach private practice, have probably seen babies who were literally hauled out of their mothers' bodies, and yet did not suffer injury. So they think that all of them can. And they cannot.

These predisposing factors need to be studied and discovered, not to absolve doctors of responsiblity or give them blanket permission to "pull as hard as possible"... but to help them understand that there will be infants who are more susceptible to injury, or more susceptible to significant injury. And to make sure that care is taken during ALL births, in order to protect the most susceptible infants from injury.

Kate

Hi!

I am not sure about the theory of getting stuck because of the extra rib or not.

I have a traumatic brachial plexus injury...so not obstretical.

Anyway, the reason i replied to this! I too have bilateral cervical ribs. I developed "thoracic outlet syndrome" - basically the extra rib was pushing on my nerves causing pain. It can also push on arteries and veins in some people causing severe problems.

I actually had surgery to remove my right cervical rib on my c7 on dec 3, 2008 becuase of it pushing on my nerves causing problems... which is what actually resulted in my TBPI - two nerves were cut during the surgery to remove the bone.

so the extra rib might be causing some problems for your nerves.

My PT did mention this to me. She seems to think that my pinky and ring finger numbness is more due to that than my injury is.

But I've been in pretty good shape since I got done with PT, I hope the stretches and my wrist brace are the answer but it's definitely something to remember if my pinky and ring finger get worse.

It was an interesting discovery.

-Traci

I was roaming some sites about my RTBPI and came across this which reminded me of this post.

* Radiographs:
- look for presence of cervical rib;
- in the report by J. Becker et al (JBJS Br. vol 84-B No 5 July 2002 - p 740), the authors noted that in a series of 42 infants found to have a cervical rib, 28 newborns had an Erb's palsy;
- they conclude that a cervical rib was a risk factor for an Erb's palsy;
- ref: The cervical rib. J. Becker et al. JBJS Br. vol 84-B No 5 July 2002 - p 740.

http://www.wheelessonline.com/ortho/erbs_palsy

looks like cervical ribs do add as a risk factor for erb's palsy at birth