Open AccessFavourable outcomes of coccygectomy for refractory coccygodynia
Author(s) -
B. Haddad,
Vivek Prasad,
Wasim Khan,
Mahbub Alam,
Stewart Tucker
Publication year - 2014
Publication title -
annals of the royal college of surgeons of england
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.39
H-Index - 63
eISSN - 1478-7083
pISSN - 0035-8843
DOI - 10.1308/003588414x13814021676675
Subject(s) - medicine , coccyx , sitting , complication , refractory (planetary science) , surgery , physical therapy , patient satisfaction , anesthesia , physics , pathology , sacrum , astrobiology
Coccygodynia is a condition associated with severe discomfort in the region of the coccyx. While traditional procedures had poor outcomes and high complication rates, recent literature suggests better outcomes and lower complication rates with coccygectomy. Methods Data were collected retrospectively from clinical notes. A questionnaire was used to evaluate the outcomes. The outcome measures included pain analogue score (PAS) in sitting and during daily activities as well as patients’ overall pain relief. Overall improvement in pain and complications were documented. Results Between 2000 and 2010, 14 patients underwent total coccygectomy for refractory coccygodynia. All patients were available for follow-up appointments and the follow-up duration ranged from 24 to 132 months (mean: 80 months). The aetiology was traumatic in eight patients and non-traumatic in six. The PAS improved from a median of 9 to 4 for sitting and from 7.5 to 2.5 for daily activities. One patient had mild discharge for more than two weeks. No patients required further surgery. Twelve patients (85.7%) had excellent or good pain relief. Only one patient was unsatisfied. A Wilcoxon signed-rank test revealed significant improvement in pain when sitting (p<0.05) and during activities of daily living (p<0.05) at the final follow-up visit. A Mann–Whitney U test did not show a significant difference in improvement in PAS between the traumatic and non-traumatic groups (p=0.282 and 0.755). Conclusions In our series, total coccygectomy offered satisfactory relief of pain in the majority of patients with a low wound complication rate.