Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 23857
COCCYGECTOMY FOR COCCYDYNIA: A CASE SERIES AND ANALYSIS
Dushan THAVARAJAH, Gareth POWELL, Alexander ASHMORE, Andrew FLOYD
Milton Keynes General Hospital, Southall (UNITED KINGDOM)
Introduction: Coccygectomy, surgical excision of the coccyx, may be used to treat
coccydynia, a chronic and disabling condition of the lowest part of the spine. It is a
controversial and infrequently performed operation that many surgeons are reluctant
to perform due to the risks of rectal perforation and infection. The criteria for patient
selection for coccygectomy remain ill-defined. We present a single surgeon case
series of 17 patients who underwent coccygectomy for chronic coccydynia. Methods:
This was a retrospective observarional case series analysis. Case notes of 17
patients who underwent coccygectomy from 1999 -2009 were obtained and
analysed. We then carried out telephone survey for which only 15 patients were
contactable. We used the Milton Keynes Orthopaedic Patient Satisfaction survey and
the modified Oswestry low back pain disability questionnaire. Results: All patients
had a 2-3yr history of coccydynia; 15 following trauma, 1 following a caudal injection
& 1 following birth delivery. All patients had received between 1 - 5
lignocaine/methylprednisolone injections prior to coccygectomy, with documented
initial symptom relief. All 17 patients had documented hypermobile sacro-coccygeal
joints. Post-operative symptom relief varied between 60 & 100%, with all patients
reporting that they would have their surgery again. Complications included 3 post
operative wound infections. There were no cases of rectal perforation. Conclusion:
Coccygectomy for intractable coccydynia is sometimes the only option available. With
good patient selection, including identification of a hypermobile joint with initial
symptom relief following local injection, coccygectomy is a successful and safe
treatment.
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