Coccygectomy for Coccygodynia: Does Pathogenesis Matter?

Pennekamp, P. H.; Kraft, C. N.; Stütz, Arndt; Wallny, T.; Schmitt, O.; Diedrich, O.

doi:10.1097/01.ta.0000195878.50928.3c

Cited by 71 publications

(94 citation statements)

References 21 publications

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“…11 Schapiro, 11 in 1950, described the disorder as 'television disease', because poor postural adaptation was thought to be an important predisposing factor of coccydynia. Maigne et al 9 reported that 36 of 51 patients had a history of direct trauma, and Pennekamp et al 7 reported a 50% incidence of direct trauma. Depending on the severity of the trauma, patients experience strain to the pelvic floor muscles, mild distortion without bony or ligamentous damage over a fissure in the caudal coccygeal segments, or a severely dislocated fracture of the sacrococcygeal complex.…”

Section: Aetiology Of Coccydyniamentioning

confidence: 99%

“…Depending on the severity of the trauma, patients experience strain to the pelvic floor muscles, mild distortion without bony or ligamentous damage over a fissure in the caudal coccygeal segments, or a severely dislocated fracture of the sacrococcygeal complex. 7 Maigne, Doursounian and Chatellier 12 reported a body mass index of more than 27.4 in women and 29.4 in men as a risk factor for the development of both idiopathic and posttraumatic coccydynia. When obese individuals attempt to sit down, the coccyx tends to jut out posteriorly as a result of inadequate sagittal pelvic rotation.…”

Section: Aetiology Of Coccydyniamentioning

confidence: 99%

“…7,25 Women are five times more commonly affected than men. 7,25 In 1950, Schapiro 11 confirmed the findings of Thiele 25 on the clinical features of coccydynia and called it Thiele syndrome. Thiele's description 25 of the clinical features still holds true today.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…3,6,7 The coccyx is a triangular bone consisting of three to five segments: the first and largest of these vertebral segments articulates with the sacrum. The last three segments diminish in size and usually form a single piece of bone.…”

Section: Pathoanatomymentioning

confidence: 99%

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Coccydynia

Nathan

Fisher

Roberts

2010

The Journal of Bone and Joint Surgery. British volume

116

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Coccydynia is a painful disorder characterised by coccygeal pain which is typically exaggerated by pressure. It remains an unsolved mystery because of the perceived unpredictability of the origin of the pain, some psychological traits that may be associated with the disorder, the presence of diverse treatment options, and varied outcomes. A more detailed classification based on the aetiology and pathoanatomy of coccydynia helps to identify patients who may benefit from conservative and surgical management.This review focuses on the pathoanatomy, aetiology, clinical features, radiology, treatment and outcome of coccydynia.Pain in the region of the coccyx is referred to as coccydynia or coccygodynia. A convoluted literature exists on its aetiology and management. The term coccydynia was first used by Simpson 1 in 1859, but descriptions of pain in the terminal portion of the spine date back to at least the 16th and 17th centuries.

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Section: Aetiology Of Coccydyniamentioning

confidence: 99%

Section: Aetiology Of Coccydyniamentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

Section: Pathoanatomymentioning

confidence: 99%

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Coccydynia

Nathan

Fisher

Roberts

2010

The Journal of Bone and Joint Surgery. British volume

116

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“…Nevertheless, wound infection is the most important complication of this procedure. In order to minimise the risk of infection, some authors [1,15,16] have suggested subperiosteal dissection and preservation of the periosteum during closure instead of total resection together with the periosteum. However, the effect of this closure on the outcomes has not been described in the relevant literature.…”

Section: Introductionmentioning

confidence: 99%

Coccygectomy with or without periosteal resection

Bïlgïç

Kürklü

Yurttaş

et al. 2009

International Orthopaedics (SICOT)

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The purpose of this study was to compare the clinical outcomes and wound complications in coccygectomy with or without subperiosteal resection. This retrospective study included 25 patients who underwent coccygectomy. Resection of all mobile coccygeal segments including the periosteum was performed in 11 patients (group 1) and resection was performed subperiostally sparing the periosteum in the remaining 14 patients (group 2). A visual analogue scale was used for pain assessment before and after the surgery both in sitting and standing positions. A questionnaire to evaluate subjective patient satisfaction was also used. The two groups were statistically similar in terms of age, sex, aetiology, duration of symptoms before surgery and follow-up time. Both surgical techniques resulted in a statistically similar clinical outcome. Overall, 84% of patients who underwent coccygectomy benefited from surgery. We observed four wound infections (two superficial and two deep) that caused delayed wound healing in group 1. The rate of infection in group 1 was statistically higher than in group 2. The results of this study suggest that periosteal preservation and closure are related to low risk of infection.

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