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

Abstract

BackgroundThis study aimed to determine the predictive factors affecting the success of ganglion impar block applied in chronic coccygodynia.MethodsPatients who received ganglion impar block to treat coccygodynia between January 1, 2018 and January 1, 2021 were retrospectively screened. Of the 195 patients, 102 met the final analysis criteria and were included in the study. Demographic data, coccygodynia etiology, coccygodynia symptom duration, history of coccyx fracture, regular opioid use, and presence of other musculoskeletal chronic pain conditions accompanying coccygodynia were obtained from patient records. In addition, coccyx radiography was examined, and coccyx curvature type, permanent subluxation, and posterior spicule presence were evaluated. The criterion for treatment success was set as ≥50% reduction in Numerical Rating Scale pain scores in the third month after treatment.ResultsTreatment was successful of the patients in 69.6% (95% CI 60.4% to 78.7%). A significant cut-off value (24.5 months) was determined for coccygodynia symptom duration using receiver operating characteristic analysis. Symptom duration above the cut-off value was defined as prolonged symptom duration. Multivariable logistic regression analysis was performed to determine the predictive factors affecting treatment success in the third month after injection. In the final model, the presence of permanent subluxation (yes vs no), and the prolonged symptom duration (yes vs no) were found to have significant effects on treatment success (OR 9.56, 95% CI 1.44 to 63.40, p=0.02; OR 137.00, 95% CI 19.59 to 958.03, p<0.001).ConclusionTreatment success of ganglion impar block for coccygodynia is high. However, longer preprocedure symptom duration and the presence of permanent subluxation were associated with a decrease likelihood of treatment success.

Evaluation of the effectiveness of caudal epidural steroid injection as an adjuvant to ganglion impar pulsed radiofrequency therapy in chronic coccygodynia

“…Chronic pain may cause irreversible changes in the brain that can adversely affect various aspects of patient well-being, including cognitive and mental health and overall quality of life, potentially making treatment even more difficult over time [ 19 , 20 ]. In a retrospective study of 102 patients with chronic coccygodynia examining the factors affecting treatment success at 3 months after GIB, a symptom duration longer than 24.5 months was associated with significantly lower treatment success [ 21 ]. Our literature search yielded no previous study examining the relationship between pain duration and the effectiveness of GI-PRF and CESI therapy.…”

Imaging findings and treatment in coccydynia – update of the recent study findings

“…Celenlioglu et al investigated the predictive factors that affect the success of GIB in chronic coccydynia and reported that prolonged symptom duration has significant effects on treatment success. The cut-off value for duration of coccydynia was two years [36]. Seker et al [37] compared manual treatment combined with steroid injections with steroid injection alone in persistent coccydynia and reported that the results of combined treatment were better and significantly reduced the recurrence rate.…”

Ganglion impar block a matter of safety and efficacy

“…We want to congratulate Dr Celenlioglu and Sir1 for their recent original research on predictive factors affecting treatment success in ganglion impar block (GIB). When our group first described the approach,2 it was thought to help patients with visceral cancer pain; nevertheless, since its first description, the indications and approaches have been evolving to different guided techniques, including fluoroscopy, CT, ultrasound and MRI.…”