Clinical anatomy of the coccyx: A systematic review

Abstract

The coccyx has been relatively neglected in anatomical research which is surprising given the population prevalence of coccydynia and our inadequate understanding of its etiology. This systematic review analyzes available information on the clinical anatomy of the coccyx. A literature search using five electronic databases and standard anatomy reference texts was conducted yielding 61 primary and 7 secondary English-language sources. This was supplemented by a manual search of selected historical foreign language articles. The coccygeal vertebrae, associated joints, ligaments and muscles, coccygeal movements, nerves, and blood supply were analyzed in detail. Although the musculoskeletal aspects of the coccyx are reasonably well described, the precise anatomy of the coccygeal plexus and its distribution, the function of the coccygeal body, and the anatomy of the sacrococcygeal zygapophyseal joints are poorly documented. Further research into the anatomy of the coccyx may clarify the etiopathogenesis of coccydynia which remains uncertain in one-third of affected patients.

CT morphology and morphometry of the normal adult coccyx

“…The coccyx (from the Greek word ''Kójjtn'' due to its resemblance to the curved beak of the cuckoo) comprises the terminal vertebral segments of the human spine [1]. When subject to pathology it can be a source of debilitating localized pain [2].…”

“…There is a remarkable paucity of data on the normal in vivo morphology and morphometry of the human adult coccyx. Most observations on the length and shape of the coccyx have been derived from studies of disarticulated skeletal material [1]. One study using plain radiography in asymptomatic adults [3] and another using computed tomography (CT) in patients with vascular or suspected bowel disease [4] have been reported.…”

Ganglion Impar Radiofrequency Ablation For Intractable Cancer Pain: A Case Report

“…11,12 Anatomical studies showed variations in the localization of this ganglion between the sacro-coccygeal joint and coccyx end. It is mostly located in front of the sacro-coccygeal joint and coccygeal vertebra.…”

Coccygectomy; Is it Worthwhile in Every Patient with a Refractory Coccygodynia? An Updated Review

“…This bone is an important structure in the pelvis the serves as an attachment for ligamentous (sacrospinous, anterior, posterior coccygeal, and lateral sacrococcygeal ligaments) and muscular structures (external anal sphincter, levator ani, and coccygeus muscles). These components prevent the sagging of pelvic contents and are responsible for bowel continence [3] .…”