The influence of etiology on the results of coccygectomy.

Clinical orthopaedics and Related Research

1984 Nov; 190: 266-272

Bayne O, Bateman JE, Cameron HU

Abstract

The results of coccygectomy for coccygodynia seem not to have been correlated with etiologic factors and were investigated in 48 cases (10 men and 38 women) with an average follow-up period of seven years. The following four etiologic groups were designated: I, direct trauma; II, spontaneous in origin; III, coccygodynia associated with spinal surgery; and IV, postpartum. Groups I and IV had a 75% recovery rate from pain and Group II had a 58% recovery rate. No satisfactory results were obtained in Group III. The incidence of infection was 16.6%. Few satisfactory results were obtained in cases of deep infection. While this operation is effective in many cases, it is seldom successful for pain associated with lumbar disc disease requiring lumbar laminectomy and spine fusion. Prophylactic antibiotic therapy is clearly indicated.

Summary by Jon Miles

This paper is particularly interesting as it is the only one that gives full details of the causes of coccydynia in each case, together with the associated medical history, the pathology report, complications of surgery and outcome in relieving pain. Other papers give summaries of complications of surgery and outcome, but not in the same detail as in this paper.

I have summarised the causes of the pain found in the 48 patients studied here in the table below. Note that two of them were caused by motor vehicle accidents, a possibility that is sometimes disputed by insurance companies.

You can also see a more detailed summary of the outcome of surgery, covering the findings of a number of medical papers.

Known cause Fall 21
Spinal fusion 7
Childbirth 4
Kicked 2
Motor vehicle accident 2
Unknown cause, associated history Anal intercourse 4
Pilonidal disease 3
No associated history 3
Spinal surgery 1
Cancer of rectum 4 years before 1

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