Why Did Rib Removal Not Work For My iliac-Costal Impingement Syndrome?
Q: Dr. Eppley,I am a 69 year old male with extreme, chronic lower back pain. I am certain that it is due to iliocostal impingement syndrome (I am 4 inches shorter than when I was younger, due to degenerative disc disease, scoliosis, and a vertebral compression fracture at L1). I have had a recent surgery to remove a portion of ribs 12 and 11 on the right side. The surgeon removed about 4 cm of each. It has not helped me, and I believe the reason is that he did not remove enough of #11. I am hoping you can answer just one question for me. You describe a case https://exploreplasticsurgery.com/plastic-surgery-case-study-subtotal-11-and-12-rib-removal-for-rib-tip-syndrome/ that is, I believe, exactly what has happened to me. You described that you would wait 4 – 6 weeks to assess the results of that case, but there is no more info. My question is, can you offer any more follow-up as to the success of that case…did the more extensive surgery help that patient? Thank you
A:I believe that patient went on to have substantial improvement. If you had an anterior approach to ribs 11 and 12 than the amount that can be removed is very limited. It takes a posterior approach to get out a substantial length of those ribs. If you really want to know the rib lengths that exists or have been removed you get a 3D CT scan.
Dr. Barry Eppley
World-Renowned Plastic Surgeon