Turkish Neurosurgery 2014 , Vol 24 , Num 4
Treatment Principles for Coccygodynia
Sedat DALBAYRAK1, Onur YAMAN2, Tevfik YILMAZ3, Mesut YILMAZ4
1Neurospinal Academy, Istanbul, Turkey
2Tepecik Education and Training Hospital, Clinic of Neurosurgery, Izmir, Turkey
3Dicle University, School of Medicine, Department of Neurosurgery, Diyarbakr, Turkey
4Neurospinal Academy, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.9505-13.0 AIM: An evaluation of treatment methods and outcomes for coccygodynia cases that do not respond to conservative treatment.

MATERIAL and METHODS: Local anesthetic and steroid injections were applied in 32 coccygodynia cases that did not respond to conservative treatment (average of 15 months). Coccyx excision was performed as surgical treatment in 25 cases that had pain relief after the injections but later re-presented with complaints. The patients’ pain levels were assessed with VAS. Postacchini classification was used for patient classification based on plain radiography.

RESULTS: 20 (62%) of the cases (the total including injection and surgery groups) had a trauma history. Majority of the cases treated with local steroid injection included patients with Type I, while the 25 cases that received surgical treatment predominantly included Type II patients. One case had post-operative skin infection, which was treated with antibiotics. It was observed by comparing pre-operative and post-operative pain scores that both methods provided significant pain relief in all patients.

CONCLUSION: While local steroid injection is an effective method of treatment for Type I patients, the coccyx removal is an effective method for controlling the pain in patients with trauma history and in Type II, III and IV patients. Keywords : Coccygodynia, Treatment, Steroid injection, Coccyx excision

Corresponding author : Onur Yaman, dronuryaman@yahoo.com