Episode Details

In this episode, join thoracic surgeon and chest wall reconstruction expert Adam Hansen, MD, to learn about slipping rib surgery in EDS.  Well known for his innovative surgeries for slipping rib syndrome (SRS), Dr Hansen has treated close to 1000 SRS patients.  Many of his patients are challenged with Ehlers-Danlos Syndrome and other skeletal hypermobility disorders.  

YOUR host, as always, is Dr. Linda Bluestein, the Hypermobility MD.

Takeaways

• Slipping rib syndrome and other chest wall disorders are often related to skeletal hypermobility.
• Evaluation and diagnosis of chest wall problems require a thorough physical exam and imaging, such as CT scans.
• Symptoms of chest wall compression syndromes include pain, breathing difficulties, and organ dysfunction.
• Emerging areas of discovery include posterior joint disorders and bridging cartilage separation.
• Self-help strategies, such as improving posture and specific exercises, can help manage chest wall problems and potentially avoid surgery. Maintaining good posture and performing exercises that strengthen the back can help alleviate slipping rib syndrome.
• Taping strategies and lifestyle changes, such as using lumbar pillows and sit-to-stand desks, can provide relief and improve posture.
• Avoid high velocity manipulation, as it can exacerbate slipping rib syndrome.
• Candidates for surgery should have a strong core, realistic expectations, and should reduce or eliminate the use of pain medications before the procedure.
• The Hansen 3.0 technique is the preferred surgical procedure for slipping rib syndrome, offering better outcomes compared to previous techniques.
• The surgery has a low rate of complications, with the most common being collapsed lungs, hematomas, and wound infections.
• There is no significant difference in outcomes between patients with hypermobility spectrum disorder and those with Ehlers-Danlos syndrome.
• The likelihood of recurrence or additional slipped ribs after repair is low when the surgery is performed correctly.
• Physicians should be aware of slipping rib syndrome and other chest wall problems and stay updated on the latest techniques and treatments. Dr. Adam Hansen teaches other surgeons how to address slipping ribs and complex chest wall reconstruction.
• He has built a network of surgeons around the world to provide local treatment options for patients.
• There is a correlation between cervical instability and slipping ribs, and both are part of the broader issue of hypermobility and skeletal disorders.
• Focusing on key areas for stability, such as the core, can have a significant impact on overall care and muscle strength.

Chapters

00:00 Introduction and Warm-up
01:03 Background and Expertise of Dr. Adam Hansen
03:14 Understanding Slipping Rib Syndrome and Other Chest Wall Disorders
09:32 Relationship Between Chest Wall Disorders and Skeletal Hypermobility
14:01 Evaluation and Diagnosis of Chest Wall Problems
21:16 Symptoms and Impact of Chest Wall Compression Syndromes
24:49 Emerging Areas of Discovery in Slipping Rib Syndrome
28:47 Evaluation of Chest Wall Problems: Physical Exam and Imaging
36:37 Abdominal Compression Syndromes and Chest Wall Disorders
41:19 Self-Help Strategies and Avoiding Surgery
43:48 Posture and Exercise
45:09 Taping Strategies and Lifestyle Changes
46:23 Avoiding High Velocity Manipulation
48:08 Qualifications for Surgery
51:18 Preparing for Surgery
53:21 Surgical Procedures
58:08 The Hansen 3.0 Technique
01:01:18 Outcomes and Complications
01:20:06 Hypermobility Spectrum Disorder and EDS
01:21:09 Male-Female Differences
01:22:11 Recurrence and Additional Slipped Ribs
01:23:49 Physician Awareness and Education
01:24:58 Teaching Other Surgeons
01:26:05 Building a Network of Surgeons