Minimally invasive endoscopic approach to perform complete coccygectomy in patients with chronic refractory coccydynia: illustrative case

Roa, Jorge A; White, Sarah; Barthélemy, Ernest J.; Jenkins, Arthur L.; Margetis, Konstantinos

doi:10.3171/case21533

Cited by 5 publications

(3 citation statements)

References 19 publications

(27 reference statements)

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“…This procedure has been termed "coccygeoplasty," and the utility has gained recent popularity. Another approach involves the use of endoscopy to circumvent the morbidities inherent to the traditional open coccygectomy 55 . The following therapeutic algorithm has been proposed by Fogel et al 4 .…”

Section: Gonnade Et Al Described Their Techniquementioning

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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Section: Gonnade Et Al Described Their Techniquementioning

confidence: 99%

Coccydynia

Daily,

Bridges,

et al. 2024

JBJS Reviews

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“…Загальними показаннями до кокцигектомії є нестабільність куприка, підвивих і куприкова спікула (остеофіт) [34]. У нашій серії ін'єкційного лікування НВ було дос татньо, щоб забезпечити тривале полегшення болю в усіх пацієнтів.…”

Section: таблиця 2 динаміка оцінки за ваш і шк (N=48)unclassified

Minimally Invasive Interventions on Ganglion Impar in Treatment of Patients with Coccygodynia

Romanukha,

Biloshytsky

2024

Ukr Neurosurg J

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Chronic pelvic pain (CPP) is usually treated conservatively, but in patients who do not respond to treatment, ganglion impar (GI) interventions are used as an alternative way to reduce pain. Objective ‒ to study the course of pain syndrome and functional status in patients with coccygodynia (CD) and CPP during the application of minimally invasive interventions on GI. Materials and methods. The analysis of the results of 56 interventions on GI in 50 patients was performed. Inclusion criteria were patients with coccyx pain for ≥3 months aged 23 to 71 years (mean age 47.9±14.8years) who did not respond to conservative treatment methods. 15 (35.7%) of the study participants were male and 27 (64.3%) were female. Interventions were performed on the patients according to five different methods, which were divided into two groups: the first group (n=34) ‒ GI block (GIB) with a local anesthetic and a steroid (patients with CD in whom medical conservative methods of treatment were not effective). The second group (n=14) consisted of persons with recurrent pain syndrome, resistant forms of CD and CPP, including after previously performed steroid injections: n=2 – neurolysis of GI with ethyl alcohol; n=2 – neurolysis of GI by phenol; n=3 – radio frequency modulation of GI; n=7 – radiofrequency ablation of GI. Results. 14.0% of all study participants had post-traumatic CD (history of falling on the coccyx), the vast majority of 86.0% ‒ idiopathic CD. Pain intensity was significantly lower post-intervention compared to baseline VAS mean of 7.6±1.5 cm: 2.5±0.9 cm one-week post-procedure, 1.5±1.9 cm one month, 1.3±1.5 cm three months, 2.1±1.2 cm six months. The average score according to the Karnovsky Scale (KS) before and after the procedure was 73.3±6.3% and 83.9±4.9%, respectively. Conclusions. Interventions on ganglion impar are an effective method of treating patients with coccygodynia of various etiology, which significantly reduce pain according to the VAS scale (p<0.001) and improve the quality of life according to the KS (p<0.001) in dynamics after 1, 3, 6 months. Minimally invasive interventions on ganglion impar make it possible to reduce tissue trauma, to quickly recover for patients after the procedure, and to minimize any complications. In the first and second groups of the study, there was a decrease in the pain on the VAS from 8.0 cm to 2.0 cm (p<0.0001) and from 7.0 cm to 2,7 cm (p<0.001) before and after the procedure, respectively. In the first and second groups of the study, there was an improvement in the indicator of functional status according to the KS from 70% (95% сonfidence interval (CI) 60‒90%) to 90% (95% CI 70‒100%, p<0.0001) and from 70% (95% CI 70‒90%) to 90% (95% CI 80‒100%, p=0.001) before and after the procedure, respectively.

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“…[31,32] The description of the disease was given back in the 1960s by Thiele, and it is still considered accurate and true. Patients describe the pain as sharp, stabbing or aching pain in the coccygeal segments [8,33] Pain can be mild but severe cases are reported with agonizing pain that affects the daily functioning of individuals. [34] Previous studies have shown that pain is experienced particularly when sitting on hard surfaces.…”

Section: Literature Reviewmentioning

confidence: 99%

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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Minimally invasive endoscopic approach to perform complete coccygectomy in patients with chronic refractory coccydynia: illustrative case

Cited by 5 publications

References 19 publications

Coccydynia

Coccydynia

Minimally Invasive Interventions on Ganglion Impar in Treatment of Patients with Coccygodynia

Coccygectomy for coccygodynia: A single-center experience

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