Factors associated with Successful Responses to Ganglion Impar Block: A Retrospective Study

Abstract

Background:The ganglion impar (ganglion of Walther) block has been used to manage coccygeal and perineal (perianal and genital) pain due to both benign and malignant causes. However, the factors associated with successful responses to ganglion impar block are unknown. Therefore, in the present study, we aimed to identify the independent factors associated with successful responses to ganglion impar block in patients with chronic pain in coccygeal and perineal regions. Methods: From January 2008 to December 2017, we performed a retrospective review of 106 patients who underwent ganglion impar block. Patients were considered successful responders if they reported a decrease of more than 50% or 4 points on the 11-point (0 = no pain and 10 = worst possible pain) numerical rating scale 1 month after the procedure, while others were considered non-responders. Logistic regression analysis was performed to identify factors independently associated with successful responses at 1 month after the procedure. Results: Multivariable logistic regression analysis showed that cancer-related causes were significantly associated with successful responses at 1 month after ganglion impar block (odds ratio = 2.60, 95% confidence interval = 1.05 to 6.43, P = 0.038). Conclusion: Ganglion impar block may be more effective in cancer-related pain than pain due to benign causes.

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

“…Gündüz et al 8 achieved >50% pain reduction with GIB in 18 of 19 patients with traumatic coccidynia. Kim et al 9 reported a VAS score reduction of >4 units with GIB in 17% of patients with non‐cancer‐related coccyx pain. This study found at least a 50% improvement in VAS score in 56% of patients with coccydynia at 1 month.…”

Predictive factors affecting treatment success in ganglion impar block applied in chronic coccygodynia

“…Although GIB has been reported to be an effective and reliable treatment for coccygodynia, there are limited studies6 10 evaluating the predictive factors for treatment response. In a retrospective study, Sencan et al 6 performed dynamic radiographic evaluations on 37 patients and examined the effect of coccygeal dynamic pattern on GIB.…”

“…In a retrospective study of 102 patients, Kim et al 10 reported that demographic data, including age, sex, and BMI, had no impact on the treatment success. Sencan et al 6 also noted no correlation between treatment success and age, sex, and BMI.…”

“…GIB was first used to treat coccygodynia of malignant origin and is still used successfully in this patient group 10. Afterwards, it was also started to be used in the treatment of non-malignant chronic coccygodynia, and its effectiveness has been well documented in many studies 2 6 8 9.…”

“…However, contradicting treatment results have been reported in patients receiving GIB, which suggests that various parameters might have an effect on the treatment outcomes. Although many risk factors have been associated with the development of coccygodynia, few studies have evaluated the impact of these factors on the success of GIB 6 10. Thus, the effects of various demographic, clinical, and radiological parameters on the success of GIB in coccygodynia are yet to be fully elucidated.…”