Coccydynia – could age, trauma and body mass index be independent prognostic factors for outcomes of intervention?

Kodumuri, Preetham; Raghuvanshi, Subhra; Bommireddy, R; Klézl, Zdeněk

doi:10.1308/rcsann.2017.0089

Cited by 22 publications

(35 citation statements)

References 15 publications

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“…Kodumuri et al. 18 investigated the factors influencing the treatment success after injection, manipulation or coccygectomy in a retrospective study. They reported high BMI and trauma history as independent risk factors for coccydynia.…”

Section: Discussionmentioning

confidence: 99%

The influence of coccygeal dynamic patterns on ganglion impar block treatment results in chronic coccygodynia

et al. 2018

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Objective Ganglion impar block (GIB) can be performed in patients with chronic coccygodynia who do not respond to conservative treatments. We investigated the effect of coccygeal dynamic patterns on the treatment outcome in patients with chronic coccygodynia treated with GIB. Materials and methods We retrospectively analyzed the data for patients diagnosed with chronic coccygodynia who underwent GIB only once by a transsacrococcygeal method under fluoroscopy guidance in our Pain Medicine Clinic. Patients were assessed with standard and dynamic coccyx radiographs and classified according to coccygeal mobility. Pain scores were assessed with a numerical rating scale (NRS) before and after the intervention (at 1 hour and 4, 12 and 24 weeks). A 50% or more reduction in the NRS score was accepted as significant pain relief. Results Of the 37 patients included in the study, 14 had normal coccyx (Group I) and 23 had immobile coccyx (Group II) based on the radiological evaluation. The NRS scores were significantly reduced in both groups on each follow-up visit but there was no significant difference between the two groups in terms of pre- and post-intervention NRS scores. Significant pain relief was achieved in 42.9% and 61.9% of patients in Group I and II at the last examination, respectively. Conclusion GIB administered by transsacrococcygeal method in patients with chronic coccygodynia is a safe and alternative treatment approach with reduced pain scores and low complication rates. In patients with chronic coccygodynia, having a normal or immobile coccyx does not appear to affect treatment outcomes.

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Section: Discussionmentioning

confidence: 99%

The influence of coccygeal dynamic patterns on ganglion impar block treatment results in chronic coccygodynia

et al. 2018

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“…The success rate of the treatment of coccydynia varies widely. It is not well understood whether treatment outcome is related to any predictable patient factors (7) . There are no standard treatment guidelines despite the existence of many modalities, including physical therapy, local infiltration of local steroids and anesthetics, caudal epidural block and neurolysis of the sacral nerve root.…”

Section: Introductionmentioning

confidence: 99%

Ganglion Impar Block in Patients With Chronic Coccydynia

Aydın¹

2019

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Objective: Coccydynia refers to pain in the terminal segment of the spine caused by abnormal sitting and standing posture. Coccydynia is usually managed conservatively; however, in nonresponsive patients, ganglion impar block is used as a good alternate modality for pain relief. This article studied the effect of ganglion impar block in coccydynia patients who were not relieved by conservative management. Materials and Methods: We retrospectively reviewed 39 patients who underwent fluoroscopy-guided trans-sacro-coccygeal ganglion impar block between April 2014 and April 2016. We included four patients with coccygeal fractures. General demographics and parameters including operative time, length of hospital stay, mean time to return to work, complications, and recurrences were recorded. Clinical outcomes were evaluated using Visual Analog Scale (VAS) for pain. Results: The study included 25 (64.1%) female and 14 (35.9%) male patients. The mean age of the patients was 48.6 years (range, 14 to 81 years). Coccydynia was the leading symptom in this series. The mean duration of symptoms was 16 months (between 1 and 36 months). All patients were followed up for a 12-month period. A significant decrease was found in the mean VAS scores. The mean preoperative VAS score was found to be 8 whereas the mean postoperative VAS score at the 12 th month was found to be 0.3. Conclusion: This study recommends the trans-sacro-coccygeal "needle inside needle" technique for local anesthetic block of the ganglion impar for pain relief in patients with chronic coccydynia. This should be integrated with rehabilitative measures including ergonomic modification for prolonging pain-free period.

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“…The aetiology is unclear and probably multifactorial, but a high proportion is attributed to trauma and childbirth. 3 - 5 …”

Section: Introductionmentioning

confidence: 99%

Corticosteroid injection for coccydynia

2020

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Aims We aimed to establish the short- and long-term efficacy of corticosteroid injection for coccydynia, and to determine if betamethasone or triamcinolone has the best effect. Methods During 2009 to 2016, we treated 277 patients with chronic coccydynia with either one 6 mg betamethasone or one 20 mg triamcinolone cortisone injection. A susequent injection was given to 62 (26%) of the patients. All were reviewed three to four months after injection, and 241 replied to a questionnaire a mean of 36 months (12 to 88) after the last injection. No pain at the early review was considered early success. When the patient had not been subsequently operated on, and indicated on the questionnaire that they were either well or much better, it was considered a long-term success. Results At the three- to four-month review, 22 (9%) reported that they had no pain. The long-term success of one injection was 15% and rose to 29% after a second injection. Logistic regression tests showed that both early success (odds ratio (OR) 5.5, 95% confidence interval (CI) 2.1 to 14.4; p = 0.001) and late success (OR 3.7, 95% CI 1.7 to 8.3; p = 0.001) was greater with triamcinolone than with betamethasone. Late success was greater for patients with symptoms for less than 12 months (OR 3.0, 95% CI 1.4 to 6.7; p = 0.006). We saw no complications of the injections. Conclusion We conclude that the effect of corticosteroid injection for coccygodynia is moderate, possibly because we used modest doses of the drugs. Even so, they seem worthwhile as they are easily and quickly performed, and complications are rare. If the choice is between injections of betamethasone or triamcinolone, the latter should be selected. Cite this article: Bone Joint Open 2020;1-11:709–714.

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Coccydynia – could age, trauma and body mass index be independent prognostic factors for outcomes of intervention?

Cited by 22 publications

References 15 publications

The influence of coccygeal dynamic patterns on ganglion impar block treatment results in chronic coccygodynia

The influence of coccygeal dynamic patterns on ganglion impar block treatment results in chronic coccygodynia

Ganglion Impar Block in Patients With Chronic Coccydynia

Corticosteroid injection for coccydynia

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