Clinical Outcomes of Coccygectomy for Chronic Coccygodynia

Dae Ho Ha; Sung Kyun Oh.; Dong Jin Shin; Dae Moo Shim

doi:10.4184/jkss.2015.22.2.50

Journal List > J Korean Soc Spine Surg > v.22(2) > 1076076

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Ha, Oh., Shin, and Shim: Clinical Outcomes of Coccygectomy for Chronic Coccygodynia

Original Article

Journal of Korean Spine Surg 2015;22(2):50-54.

Published online: 21 June 2015

DOI: https://doi.org/10.4184/jkss.2015.22.2.50

Clinical Outcomes of Coccygectomy for Chronic Coccygodynia

Dae Ho Ha, M.D., Ph.D., Sung Kyun Oh., M.D., Dong Jin Shin, M.D., Dae Moo Shim, M.D., Ph.D.^∗

^∗Department of Orthopedic Surgery, Wonkwang University, Gunpo, Korea Department of Orthopedic Surgery, School of Medicine, Wonkwang University Hospital, Iksan, Korea

Institute of Wonkwang Medical Science, Iksan, Korea

Corresponding author: Sung Kyun Oh, M.D. Department of Orthopedic Surgery, School of Medicine, Wonkwang University Sanbon Hospital, Sanbondong, Gunpo city, Gyeongido, Korea TEL: +82-31-390-2992, FAX: +82-31-390-2244 E-mail: niceo@hanmail.net

*This paper was supported by Wonkwang university in 2015

Received 29 September 2014 Revised 5 January 2015 Accepted 11 May 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Retrospective study.

Objectives

To confirm the clinical outcomes of coccygectomy for intractable chronic coccygodynia.

Summary of Literature Review

Coccygectomy has been reported to be one of the good options for the failure of conservative treatment.

Materials and Methods

A retrospective review was conducted, including nine patients who underwent coccygectomy for intractable chronic coccygodynia.

Results

Improvements in the mean visual analogue scale (VAS) scores, from 5.6 to 2.1, were observed. As for patient satisfaction, there were four cases with excellent outcomes, three with good outcomes, one with a fair outcome, and only one with a poor outcome. Surgical complications, such as wound infection, did not occur in any of the cases.

Conclusions

Irrespective of the causes, coccygectomy for chronic coccygodynia, for which nonsurgical management, including cushions, nonsteroidal antiinflammatory drugs, and corticosteroid injections, has no effect, is considered a useful method because it

Keywords: Coccygodynia, Coccygectomy

REFERENCES

1. Balain B, Eisenstein S.M, Alo G.O, et al. Coccygectomy for coccydynia: case series and review of literature. Spine (Phila Pa 1976). 2006; 31:414–20.

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Figures and Tables%

Fig. 1.

Photograph of prominent coccyx.

Fig. 2.

Preoperative lateral radiographs of the case (A) show anterior subluxation of the coccygeal mobile segment. (B) Magnetic resonance (MR) sagittal view also showing anterior sharp angulation of the coccygeal mobile segment.

Fig. 3.

(A) Mobile coccygeal segment is observed through a proximal transverse incision. (B) Postoperative lateral radiograph showing removed state of coccygeal segment. (C) Postoperative photograph of the surgical wound.

Table 1.

Coccyx Configuration According to Postacchini and Massobrio, and Classification of Our Patients

Type	Definition	Total 9
I	Coccyx is slightly curved forward	0
II	Curve is more marked and the coccyx points straight forward	1
III	Sharp forward angulation	5
IV	Subluxation in the sacrococcygeal or intercoccygeal joints	3

Table 2.

Outcomes of Coccygectomy

Case number	Age/Gender	Etiology	Incision	Type of configuration of the coccyx	Outcome
1)	33/F	atraumatic	transverse	Type 4	excellent
2)	12/F	atraumatic	transverse	Type 3	excellent
3)	33/F	atraumatic	transverse	Type 4	excellent
4)	36/M	atraumatic	transverse	Type 2	good
5)	48/F	atraumatic	vertical	Type 4	fair
6)	46/F	atraumatic	vertical	Type 3	excellent
7)	37/M	traumatic	vertical	Type 3	poor
8)	42/M	atraumatic	vertical	Type 3	good
9)	40/F	traumatic	vertical	Type 3	good

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