Coccygectomy in the Treatment of Chronic Coccydynia

Kalstad, Ante Matti; Knobloch, Rainer G; Finsen, Vilhjalmur

doi:10.1097/brs.0000000000004209

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…Antibiotics are found to significantly reduce the infection rate and have been widely adopted as an effective post-operative practice. [23,24,53,54] Wound complications are regarded as the most frequent complication; however, it was shown in a study of 10 cases of coccygectomy that using “Z” plasty closure resulted in no wound infection among all the cases. [37] A review of treatments for coccygodynia, such as physical therapy, local injections, and surgical procedure, was conducted.…”

Section: Discussionmentioning

confidence: 99%

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Coccygectomy for coccygodynia: A single-center experience

İZCİ

Keskin

2023

Medicine

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Spine fractures are most commonly observed among older people due to weak bones and irregular postures. These fractures of 10 lead to coccygodynia. Women are 5 times more prone to developing coccygodynia as compared to men. Initially, different painkillers, physiotherapy, and other non-surgical treatments are recommended to reduce the pain. However, in case of the failure of these treatments, a surgical procedure (named coccygectomy) is considered to remove the tailbone to achieve effective outcomes. The main aim of this study is to determine the effectiveness of coccygectomy in treating coccygodynia (after the failure of different non-surgical treatments) in the context of patients who were treated at Konya City Hospital neurosurgery department, Turkey. In this study, a total of 14 cases of coccygodynia treated with coccygectomy at Konya City Hospital were selected from the period of August 2020 and January 2022. These patients were given different treatments for 6 to 7 months before the operation. Therefore, due to the lack of positive outcomes, a coccygectomy was performed by a senior surgeon. Visual analogue scale was used to assess the pain of the patients after the surgery. Statistical Package for the Social Sciences was used for statistical analysis. The level of significance was set at P < .05. The results of this study showed that more women suffered from coccygodynia as compared to men. Most of the patients had Type I (35.7%) and Type IV (35.7%) coccyx. The visual analogue scale was reduced after the surgery (P < .0011), showing positive outcomes. Ten (71.4%) cases showed excellent outcomes, whereas only one (7.1%) case showed poor outcomes after the surgery, and wound infections were observed in two (14.2%) cases post-operatively. The results obtained from this study concluded that in case of failure of conservative non-surgical treatments for coccygodynia, coccygectomy has emerged as an effective surgical method which is recommended by various surgeons to reduce the pain by removing the tailbone. Additionally, only a few complications such as infection as a relevant concern after this type of surgery were observed, and most of the patients were satisfied with the outcomes and also recommended it to others.

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Section: Discussionmentioning

confidence: 99%

“…[3,11,22] Wound infection is stated to be one of the most common complications. [23,24] Radiographs are generally used in the diagnosis. Hypermobility and subluxation are commonly seen in radiographs.…”

Section: Introductionmentioning

confidence: 99%

Coccygectomy for coccygodynia: A single-center experience

İZCİ

Keskin

2023

Medicine

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“…In the study by Ante M Kalstad et al 71% pain reduction was found in patients who underwent coccygectomy. 13 In a systematic meta-analysis review by Sagoo et al 14 21 coccygectomy studies were evaluated. The mean coccygectomy treatment success rate was 74% and the complication rate was 8%.…”

Section: Discussionmentioning

confidence: 99%

“…Another method used in patients with refractory coccydynia is coccygectomy. In the study by Ante M Kalstad et al 71% pain reduction was found in patients who underwent coccygectomy 13 . In a systematic meta‐analysis review by Sagoo et al 14 21 coccygectomy studies were evaluated.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound‐Guided Coccygeal Nerve Radiofrequency Ablation and Steroid Injection: Combination Therapy for Coccydynia

Can,

Yildiz,

Akkaya

et al. 2023

J of Ultrasound Medicine

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ObjectivesCoccydynia is characterized by pain in tailbone region, which affects the quality of life. Various interventional procedures are performed for coccydynia that is unresponsive to conservative treatment. This study aimed to evaluate the efficacy of ultrasound (US)‐guided radiofrequency ablation (RFA) and steroid injection of the coccygeal nerve in patients with idiopathic and traumatic coccydynia.MethodsIn this prospective study, 32 patients with coccydynia unresponsive to conservative treatments underwent US‐guided RFA of the coccygeal nerve. Coccygeal nerves were visualized at the level of the coccygeal cornua with US, 1 mL lidocaine 2% was injected into both areas and radiofrequency ablation was performed at 90°C for 60 seconds. After RFA, 2 mL dexamethasone and 2 mL bupivacaine 0.5% were injected. Visual Analog Scale (VAS) and Paris scales were used to evaluate the effect of treatment on pain and functionality before and at 1, 4, and 12 weeks after treatment.ResultsWe found that 54% of the patients had a >50% reduction in VAS score and 66% of the patients had a >50% reduction in Paris scores measured between baseline and week 12. Additionally, the main effect of time on the VAS and Paris scores was statistically significant (P < .001) in all measurements. Baseline P and VAS scores were higher than the post‐treatment measurements (P < .001).ConclusionsOur study showed that US‐guided steroid injection and RFA of the coccygeal nerve for chronic coccydynia significantly improved pain and function scores at weeks 1, 4, and 12. RFA also results in a lower rate of adverse events. This study is the first clinical trial of ultrasound‐guided coccygeal nerve RFA in patients with coccydynia. We believe that this new less invasive method may be an alternative to other interventional treatments.

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“…Because of the proximity to the anus, a coccygectomy is at particular risk of wound infection, osteomyelitis, and pelvic floor collapse 35 . Despite this, many of the studies that have been published have reported favorable outcomes and remain the popular choice for surgery 11,21,23,34,36-49 (Table III). Pennekamp et al compared coccygectomy outcomes for a total of 16 patients for which half of these suffered traumatic causes of coccydynia, whereas the remaining half complained of idiopathic 10 .…”

Section: Treatment: Nonoperative and Operativementioning

confidence: 99%

Coccydynia

Daily,

Bridges,

et al. 2024

JBJS Reviews

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» Coccydynia is a painful condition affecting many patients at the terminal caudal end of the spine.» An understanding of coccyx anatomy and variations of morphology is necessary for proper diagnosis. A multifactorial etiology for pain may be responsible for this clinical entity.» Several treatment options exist. Successful outcomes for patients depend on individual patient characteristics and the etiology of pain.

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Coccygectomy in the Treatment of Chronic Coccydynia

Cited by 8 publications

References 26 publications

Coccygectomy for coccygodynia: A single-center experience

Coccygectomy for coccygodynia: A single-center experience

Ultrasound‐Guided Coccygeal Nerve Radiofrequency Ablation and Steroid Injection: Combination Therapy for Coccydynia

Coccydynia

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