Coccygodynia: Surgical treatment (PDF version of full paper here)

Acta Ortopédica Brasileira

2002 10(4) 26-30

Alceu Gomes Chueire (alceuchu@zipmail.com.br), Guaracy Carvalho Filho, Luciano Barboza De Souza

Departamento de Ortopedia e Traumatologia da Faculdade de Medicina de São José do Rio Preto - SP - FAMERP, Brazil

Summary

The coccygodynia is a clinical condition that is characterised by tumescence and by ache in the coccyx area. It can be related with trauma or with anatomic conformation of this area. The coccygodynia occurs more frequently in women. We report that in the medical treatment it must use conservative strategies and only when those strategies fail it is indicated the surgical treatment which gives good results. The aim of this study is to evaluate the surgical treatment by coccygectomy with 12 patients being evaluated showing good results in 10 cases, regular in 2 cases and no bad results.

Summary by Jon Miles:

Seven men and five women had coccydynia which did not respond to other treatments. Their coccyxes were removed. A vertical cut of 6 centimetres was made over the coccyx, and layers of tissue cut to reveal the coccyx and its joint with the sacrum. The coccyx was removed and the surface of the sacrum smoothed down. The overlying tissue was sewn back in layers, ensuring that there was a pillow of fat over the area to protect it. Drainage of the wound was not used. Antibiotics were given to all patients to prevent infection.

After two months, 10 of the patients had no pain, and two had light pain requiring occasional use of narcotics. The two with the remaining pain were given injections of xylocaine plus steroid twice, with a 15 day gap. After 6 months none of the 12 patients had any pain. No post-operative complications were observed.

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