Zeitschrift fur Orthopadie und ihre Grenzgebiete
2003 Sep-Oct; 141(5): 578-82.
Pennekamp PH, Kraft CN, Wallny T, Schmitt O, Diedrich O.
Klinik und Poliklinik fur Orthopadie, Rheinische Friedrich-Wilhelms-Universitat Bonn.
AIM: Excision of the coccyx for the treatment of therapy-resistant coccygodynia is a disputable management option. Due to the low morbidity only few studies concerning the long-term follow-up after coccygectomy exist. The aim of this study is a retrospective analysis of our patients surgically managed for coccygodynia and a critical review of the results obtained in comparison to the literature.
METHOD: 12 patients with complete radiographic and clinical data were included in the study. The average age of patients at the time of surgery was 43.3 years (11 - 75 years). The average follow-up was 9.8 years (2 - 16 years). As suggested by Hambly (1989) the clinical result was assessed according to postoperative pain status and subjective patient satisfaction.
RESULTS: 9 of 12 patients regarded the surgical intervention as a success and claimed that they would repeat the procedure (75 %). Three patients did not show marked improvement after coccygectomy. All patients (n = 6) surgically managed for traumatically induced coccygodynia had a positive result, while only 3/6 patients treated for idiopathic coccygodynia reported that symptoms were postoperatively reduced.
CONCLUSION:According to our results and review of those documented in the literature, excision of the coccyx for the treatment of coccygodynia, after all conservative treatment options have been exhausted, seems a justifiable alternative. Patients with a history suggestive of traumatically induced coccygodynia are more likely to benefit from coccygectomy.
Language of publication: German