Coccygectomy for the Treatment of Therapy-Resistant Coccygodynia

Coccygodynia (pain in the region of the coccyx) has many causes, but it may be posttraumatic
beginning after a fracture or contusion. Pain is typically triggered by or occurs while sitting. Nonsurgical management, including cushions, nonsteroidal anti-inflammatory drugs, and corticosteroid injections, can be successful in up to 85% of patients. The objective of the study was to show that coccygectomy can be a successful surgical treatment for patients who fail nonoperative treatment. This study is a retrospective analysis of all patients who underwent a coccygectomy performed by one surgeon between the years 2002 and 2008. All patients were asked to complete an Oswestry low back pain disability questionnaire and a visual analog pain scale. The average Oswestry disability score was 25.75%. The average visual analog score was 3.4 cm. Four patients sustained a wound breakdown. The study concluded that for patients with conservative therapy-resistant coccygodynia, operative treatment with coccygectomy is a feasible management option. (Journal of Surgical Orthopaedic Advances 18(3):147–149, 2009)