Can Rib Removal Correct An Asymmetry From Scoliosis?

Q: Dr. Eppley, I have a scoliosis that caused me to have deformity of my rib cage. Also, on my left side I have a rib that is causing me pain (I believe that it is touching a nerve or something) I would like your opinion on what are my options and what can be done to relieve me from my pain and make me look more symmetrical. Thank you!

A: Thank you for your inquiry and sending your pictures. Your scoliosis and and waistline asymmetry are very apparent. (see attached) Since your pain is on the left side (shorter side from the scoliosis) it is very possible that rib #12 is impinging on the iliac crest (ilio-costal syndrome)  While this can occur in any patients with elongated lower ribs the scoliosis patient is more at risk for it due to the twist in the ribcage. It would take either a plain x-ray ( or more ideally a 3D CT scan) of your spine and ribcage for confirmation. If so pain relief is usually achieved by shortening ribs #11 and #12.

From an asymmetry standpoint this is a bit more challenging since we can’t change the foundational position of the spine and the attached ribs. One option is to consider differential lower rib removals of #11 and #12…more on the right than the left. The effectiveness of that approach requires a good understanding of the lower ribcage anatomy from a 3D CT scan.

Dr. Barry Eppley

World-Renowned Plastic Surgeon