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The e-mémoires of the Académie Nationale de Chirurgie

Surgical management of coccygodynia

DOURSOUNIAN L | MAIGNE JY

Seance of wednesday 18 may 2005 (pas de sujet Principal)

Abstract

The advent of a dynamic radiography technique for patient withchronic coccygeal pain showed coccygeal instability. There are twopatterns: posterior subluxation of the coccyx when sitting and hyperflexionof the coccyx when sitting. Patients who did not obtainrelief from conservative management where offered surgery. Between1993 and 2000, 61 patients with instability-related coccygodyniawhere operated on. There were 49 women and 12 men,mean age 45.3 (18-72) years. Twenty seven patients had hypermobilityof the coccyx and 33 subluxation. One case had a mixedpattern. In all cases, the unstable portion was removed. Follow-upwas between 12 and 30 months. The outcome was rated excellent orgood in 53 patients, fair in 1 and poor in 7. There were 9 patientswith infection requiring reoperation. Between 2002 and 2005, 48others patients were operated on with a new technique of woundclosure. These patients are currently under evaluation concerningpain relief and among them there are only 2 cases of postoperativeinfection