Coccygectomy for posttraumatic coccygodynia: a long-term prospective study

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Background:Coccygodynia is pain around the coccyx; its most common etiology is trauma. About 20% of patients do not respond to conservative measures in the form of medical treatment, local injection, or physical therapy. Our prospective clinical study aims at highlighting the results of coccygectomy for coccygodynia caused by trauma that could not be treated conservatively.Methods:Thirty eight patients were included in the study with 28 women (73.7%) and 10 men (26.3%). After failure of conservative treatment measures, coccygectomy was done in all patients. The duration of symptoms before the surgical procedure varied between 9 and 48 mo with a mean of 19.6 mo. Clinical presentation of the local pain was quantified according to a visual analog scale (VAS) on deep manual palpation at the tip of coccyx preoperatively and at 4 mo, 12 mo, then at 2-year and 4-year follow-up.Results:The mean preoperative VAS was 9.2, at 4 mo it was 2.7, and at 12 mo it was 1.8. At 2 and 4-year postoperative follow-up, VAS was 1.5 and 1.3, respectively (P=0.0001).Conclusion:Coccygectomy for coccygodynia caused by a traumatic event affords significant pain relief postoperatively. Coccygectomy is recommended as a last resort treatment for coccygodynia after failed conservative treatment.Level of Evidence:Level IV (prospective study).

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