Sacrococcygeal Pain Syndromes: Diagnosis and Treatment

Traycoff, Roger B.; Crayton, Hulon E.; Dodson, Rebekah

doi:10.3928/0147-7447-19891001-14

Cited by 41 publications

(2 citation statements)

References 10 publications

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“…[18] Care must be taken to exclude patients with offending local pathological conditions or atypical symptoms from consideration for coccygectomy. Primary coccygodynia is distinguished from referred coccygodynia (so-called pseudococcygodynia) [19] by infiltrating the periosteum at the tender point with 10 ml of 0.25% bupivacaine and 40 mg of methylprednisolone acetate, which will elicit temporary symptomatic relief in primary coccygodynia.…”

Section: Differential Diagnosismentioning

confidence: 99%

Coccygectomy for coccygodynia: A single center experience over 5 years

2018

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Introduction:Coccygodynia refers to a pathological condition in which pain occurs in the coccyx or its immediate vicinity. The pain is usually provoked by sitting or rising from sitting. Several studies have reported good or excellent results after coccygectomy especially in patients who are refractory to conservative treatment.Aims and Objectives:This study aims to evaluate the role and effectiveness of coccygectomy in chronic refractory coccygodynia.Materials and Methods:Between January 2011 and January 2015, 16 consecutive patients (4 males and 12 females) who underwent surgical coccygectomy were enrolled prospectively in the study. All patients suffered from treatment-resistant coccygodynia and had exhausted conservative therapeutic options for at least 6 months before undergoing surgery. The same surgeon performed a complete coccygectomy on all patients. Postoperative outcomes included measurements of pain relief and degree of patient satisfaction with the procedure's results.Results:The average age of patient was 37.93 years (range: 25–53 years), and the male to female ratio was 1:3. The median duration of patient-reported symptoms prior to surgery was 24 months. The most common cause of coccygodynia was direct or indirect trauma, recorded in 11 patients (68.75%). Idiopathic coccygodynia was five cases (31.25%). The number of patients with outcomes rated as “excellent,” “good,” “fair,” and “poor” were 12, 2, 1, and 1, respectively. The favorable result (excellent or good) was 87.5%. The self-reported visual analog scale (VAS) was significantly improved by surgery. The mean VAS preoperatively was 9.62, and postoperatively it was 2.25 (P < 0.001). There were two infections (12.5%) among the 16 patients which were managed conservatively.Conclusions:Coccygectomy for chronic intractable coccygodynia is simple and effective, with a low complication rate.

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Section: Differential Diagnosismentioning

confidence: 99%

Coccygectomy for coccygodynia: A single center experience over 5 years

2018

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“…Despite a large number of coccygeal nerves are present in human embryos (up to a total of five), all but the first pair regress during embryo development 12. The paired coccygeal nerves join posteriorly with the primary posterior rami of the fourth and fifth sacral segments and together innervate the skin and soft tissue of the dorsal coccyx 13. The termination of coccygeal nerves is the anococcygeal nerves,14 which provides sensory innervation to the skin over the coccyx 15.…”

Section: Discussionmentioning

confidence: 99%

Novel approach for pericapsular radiofrequency ablation of sacrococcygeal junction for patients with coccydynia

Feigin

Wang

Grazia

et al. 2022

Reg Anesth Pain Med

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IntroductionCoccydynia is a multifactorial complex clinical challenge. A multimodal approach with both conservative measures and procedural interventions is often recommended. We described a novel approach of radiofrequency (RF) ablation for the management of coccydynia.MethodsThree patients with known history of coccydynia refractory to conservative therapy were referred to our clinic. All received different types of RF ablation before: one with anterior bipolar lesion with no analgesia benefit, one with posterior stripped lesion with good benefit but only after 8 weeks of pain flare and one received anterior monopolar lesion with 50% pain reduction for 2–3 months. All subjects underwent a novel RF ablation to the anterior surface of the sacrococcygeal and intercoccygeal joints with two bipolar lesions using multi-tined needles under fluoroscopy guidance. One bipolar lesion was between two needles: one in the sacrococcygeal and another in the intercoccygeal (between first and second coccyx) joints. Another bipolar lesion was between needles on both side of the sacrococcygeal joint.ResultsAll experienced at least 65% pain relief for 6 months. The sitting endurance increased from less than 5 min to an average of 70 min. No adverse effect was observed in two and in the patient who used to have pain flare after lesioning, the pain flare lasted only for 2 weeks.DiscussionThe configuration of the two bipolar lesions with multi-tined needles in this case series stimulates the thinking of new approach for the ablation technique for pain from coccyx. Further prospective large case cohort study is needed.

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Functional Bowel Disorders for the Colorectal Surgeon

Ayscue

Kumar

2016

The ASCRS Textbook of Colon and Rectal Surgery

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Sacrococcygeal Pain Syndromes: Diagnosis and Treatment

Cited by 41 publications

References 10 publications

Coccygectomy for coccygodynia: A single center experience over 5 years

Coccygectomy for coccygodynia: A single center experience over 5 years

Novel approach for pericapsular radiofrequency ablation of sacrococcygeal junction for patients with coccydynia

Functional Bowel Disorders for the Colorectal Surgeon

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