"cervical rib" is not a diagnosis, this is an anatomical feature which may or may not be implicated in the aetiology of cervicothoracic protective responses leading to pain or dysfunction. The important thing to remember is that wether these protoribs are implicated or not , the approach that has the best chance of achieving good results is the same as if the same features were not present. This being , to restore normal movement dynamics to the spine.