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

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


Study Design

Retrospective study.


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.


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.


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


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.
2. Fogel G.R., Cunningham P.Y.3rd, Esses S.I. Coccygodynia: evaluation and management. J Am Acad Orthop Surg. 2004; 12:49–54.
3. Patel R, Appannagari A, Whang P.G. Coccydynia. Curr Rev Musculoskelet Med. 2008; 1:223–6.
4. Postacchini F, Massobrio M. Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg Am. 1983; 65:1116–24.
5. Feldbrin Z, Singer M, Keynan O, et al. Coccygectomy for intractable coccygodynia. Isr Med Assoc J. 2005; 7:160–2.
6. Traub S, Glaser J, Manino B. Coccygectomy for the treatment of therapy-resistant coccygodynia. J Surg Orthop Adv. 2009; 18:147–9.
7. Wood K.B, Mehbod A.A. Operative treatment for coccygodynia. J Spinal Disord Tech. 2004; 17:511–5.
8. Maigne JY, Chatellier G, Faou ML, et al. The treatment of chronic coccydynia with intrarectal manipulation: a randomized controlled study. Spine (Phila Pa 1976). 2006; 31:621–7.
9. Wray C.C, Easom S, Hoskinson J. Coccydynia. Aetiology and treatment. J Bone Joint Surg Br. 1991; 73:335–8.
10. Bilgic S, Kurklu M, Yurttas Y, et al. Coccygectomy with or without periosteal resection. Int Orthop. 2010; 34:537–41.
11. Trollegaard AM, Aarby NS, Hellberg S. Coccygectomy: an effective treatment option for chronic coccydynia: retrospective results in 41 consecutive patients. J Bone Joint Surg Br. 2010; 92:242–5.
12. Cebesoy O., Guclu B., Kose K.C., et al. Coccygectomy for coccygodynia: do we really have to wait? Injury. 2007; 38:1183–8.
13. Hong CH, Lee TK, Kim SB, et al. Coccygectomy for Treatment of Coccygodynia. J Korean Orthop Assoc. 2014; 49:209–13.

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
Similar articles