Rib Removal for Costo-Iliac Syndrome

Q: Dr. Eppley, I had surgery for scoliosis in the decades ago. My ribs literally touch my hip bones when I sit or bend. I have a hard time finding pants that sit low enough on my hips in order to keep them from trying to dig in to the very small space that is there. (maybe a finger width). I am looking to help correct this issue which I hope would leave me less boxy looking as well.

A:  What you are describing is known as Costo-Iliac syndrome, a well known ribcage problem in which the lower ribs extend down and impinge on the hip when bending over. Whether this is due to the free floating ribs being too long (rib #12) or being angulated too much downward can be debated. Please send me some pictures of your body/waist for my assessment. By your  very own description the bottom floating ribs could be removed to increase the costal-iliac distance. This may also give you more of a waistline narrowing effect to make you look less boxy. This is most effectively down by removing ribs #10 and #11 as well. Technically this rib removal is subtotal removing the outer half of the rib length.

Dr. Barry Eppley

Indianapolis, Indiana