The levatores costarum are 12 pairs of small muscles arising by tendinous slips from the transverse processes of C7-T11 and inserting onto the outer surface of the ribs immediately below. Their short tendons are the primary points of force application for rib elevation during inspiration.
The levatores costarum tendons are injured in costovertebral joint injuries and rib stress fractures. They are encountered during posterior thoracic approaches and costotransversectomy procedures. Costotransverse joint injection targets the adjacent levatores costarum attachment for thoracic wall pain management.
Traction injury to the levatores costarum tendons at the costovertebral junction producing posterior thoracic pain exacerbated by deep inspiration and trunk rotation.
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