The ligamentous attachments of the first rib head to the T1 vertebra, different from ribs 2-9 as the first rib articulates with a single vertebra rather than two adjacent ones.
Anchors the first rib to the vertebral column at a single articulation, participating in thoracic inlet stability.
The first costovertebral joint is at risk during first rib resection for thoracic outlet syndrome — the anterior portion of the first rib is removed while the head is left attached to T1. Cervical rib articulates with C7 via a similar ligamentous structure.
Anterior first rib resection for thoracic outlet syndrome preserves the first rib head attachment to T1 via the costovertebral ligament, avoiding disruption of the C8-T1 nerve roots.
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