Acute traumatic instability of the coccyx: results in 28 consecutive coccygectomies

European Spine Journal

2013 22 (Supplement 6): S939–S944

Ramieri A, Domenicucci M, Cellocco P, Miscusi M, Costanzo G.

Orthopaedic Service, The Don Gnocchi Foundation of Milan, Via C. G. Bertero, 49, 00156 Rome, Italy

Email: Alexramieri@libero.it

Abstract

INTRODUCTION:

Coccygeal instability includes hypermobility, subluxation and fracture-dislocation. Surgical resection is still controversial, with intractable post-traumatic coccygodynia being an indication to surgery.

MATERIALS AND METHODS:

From 2001 to 2010, we enrolled 31 patients with post-traumatic coccygodynia (19 females, 12 males; mean age 31 years, range 21-47). Conservative treatment failed in 28 patients, who underwent surgical resection of the coccyx. Twenty-one were total, while seven were partial coccygectomies. At follow-up (mean 33 months; range 24-70), clinical outcomes evaluation included measurement of complications rate, pain relief and satisfaction degree.

RESULTS:

Nineteen patients experienced complete pain relief, while two had incomplete, and four had no relief. Partial coccygectomies were associated with poor results. Twenty-one patients were satisfied, whilst four were not.

CONCLUSIONS:

Coccygectomy is the treatment of choice for post-traumatic instability. Patients' selection allowed excellent or good results. This study favors a more aggressive approach including total resection of the coccyx.

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