Left cervical rib presenting with combined neurovascular compromise

Cervical rib is a rare congenital anomaly arising from the seventh cervical vertebra and is a recognized cause of thoracic outlet syndrome. Although most individuals remain symptomatic, some develop significant neurovascular complications due to compression of adjacent structures. We report a case of a 26-year-old female presenting with a two-year history of left upper limb pain, numbness, and paresthesia with recent progression. Clinical examination revealed the absence of distal pulses and neurological deficits in the affected limb. Imaging demonstrated arterial compression with thrombosis of the radial artery. The patient underwent surgical excision of the cervical rib via a supraclavicular approach. Intraoperatively, the cervical rib was found to be compressing the neurovascular bundle, including the subclavian vessels and brachial plexus. Complete excision of the cervical rib along with its periosteum was performed. Postoperative recovery was satisfactory with improvement in vascular perfusion and neurological symptoms. This case highlights the importance of early diagnosis and timely surgical intervention in preventing irreversible neurovascular complications.