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J Anaesthesiol Clin Pharmacol 2021 Jan-Mar;37(1):90-96. Epub 2021 Apr 10.

Department of Orthopaedics, Pt. B.D. Sharma PGIMS, Rohtak, Haryana, India.

Background And Aims: Coccygodynia or Coccydynia is pain in the area of coccyx and ganglion impar block is commonly used technique for treatment of coccygodynia.

Material And Methods: Forty patients of either sex in the age group of 20-70 years suffering from coccygodynia, who failed to respond to six weeks of conservative treatment were enrolled in the study. All patients were subjected to detailed clinical history, examination in the Pain Management Centre (Pain Clinic) of our Institute and imaging studies were reviewed. Read More

Am J Phys Med Rehabil 2021 May 28. Epub 2021 May 28.

Associate Professor, Neuromusculoskeletal Research Center, Department of physical medicine and rehabilitation, Iran University of Medical Sciences, Tehran, Iran Department of physical medicine and rehabilitation, Iran University of Medical Sciences, Tehran, Iran. Professor, Neuromusculoskeletal Research Center, Department of physical medicine and rehabilitation, Iran University of Medical Sciences, Tehran, Iran Assistant Professor, Neuromusculoskeletal Research Center, Department of physical medicine and rehabilitation, Iran University of Medical Sciences, Tehran, Iran.

Objective: Extracorporeal Shockwave Therapy (ESWT) emerged recently for the treatment of musculoskeletal conditions owing to its regenerative and anti-inflammatory effects. In this study, we aimed to compare the efficacy of ESWT and steroid injection in patients with coccydynia.

Design: Thirty-four patients with coccydynia were randomized into two groups. Read More

J Indian Assoc Pediatr Surg 2021 Mar-Apr;26(2):102-106. Epub 2021 Mar 4.

Department of Paediatric Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.

Aims: Coccygodynia (also known as coccydynia and coccyalgia) described for the first time by Simpson in 1859. It is a disabling pain in the coccyx usually provoked by sitting or changing position from a sitting to a standing position. Treatment started with adjustment of ergonomics as specialized cushion for sitting, application of local heat, and oral analgesics. Read More

Basic Clin Neurosci 2020 Nov-Dec;11(6):753-763. Epub 2020 Nov 1.

Neuromusculoskeletal Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

Introduction: Pelvic floor muscles dysfunction is one of the most important etiologies of coccydynia; therefore, manual therapies have been proposed as the first line of treatment. The purpose of this study was to investigate the effect of biofeedback as a new approach in the treatment of coccydynia.

Methods: Thirty women were randomized into two groups. Read More

J Clin Orthop Trauma 2021 Jan 24;12(1):123-129. Epub 2020 Sep 24.

Department of Orthopaedic Surgery, All India Institute of Medical Sciences, Rishikesh, 249203, Uttarakhand, India.

Coccydynia is a disabling condition characterized by pain in the coccyx region of the spine. The first description of the disease was given in as early as 1859. Since then a number of theories have been proposed by various researchers to explain the pathogenesis of the disease. Read More

Bone Joint J 2021 Mar;103-B(3):542-546

Center for Spine Surgery & Research, Sygehus Lillebælt Middelfart Sygehus, Middelfart, Denmark.

Aims: The aim of this study was to investigate the efficacy of coccygectomy in patients with persistent coccydynia and coccygeal instability.

Methods: The Danish National Spine Registry, DaneSpine, was used to identify 134 consecutive patients who underwent surgery, performed by a single surgeon between 2011 and 2019. Routine demographic data, surgical variables, and patient-reported outcomes, including a visual analogue scale (VAS) (0 to 100) for pain, Oswestry Disability Index (ODI), EuroQol five-dimension questionnaire (EQ-5D), and the Physical Component Score (PCS) and Mental Component Score (MCS) of the 36-Item Short-Form Health Survey questionnaire (SF-36) were collected at baseline and one-year postoperatively. Read More

J Osteopath Med 2021 Jan;121(1):85-96

Department of Obstetrics and Gynecology (Drs Faloon and Brock) , Maine Dartmouth Neuromusculoskeletal Medicine Plus One (Dr Bishop) and the Center for Outcomes Research and Evaluation, Maine Medical Center , Portland , ME , USA.

Context: Osteopathic manipulative medicine (OMM) has been shown to successfully alleviate some pregnancy-related pain. However, most of the published data focuses on the third trimester and postpartum period or musculoskeletal indications.

Objective: To explore OMM use among obstetrical providers and determine the frequency of use by trimester and by clinical indications across multiple types of women's healthcare practices in Southern and Central Maine. Read More

Orthop Rev (Pavia) 2020 Nov 24;12(3):8813. Epub 2020 Nov 24.

Department of Orthopaedic Surgery, St. Olav's University Hospital, Trondheim.

We wished to determine if coccygectomy as an outpatient procedure is a safe alternative to inpatient treatment. 68 patients were treated at our institution with coccygectomy as an outpatient procedure during a seven-year period. Out of these 61 (90%) responded to final follow-up questionnaires after a minimum of one year. Read More

Bone Jt Open 2020 Nov 2;1(11):709-714. Epub 2020 Nov 2.

Department of Orthopaedic Surgery, St. Olav's University Hospital, Trondheim, Norway.

Aims: We aimed to establish the short- and long-term efficacy of corticosteroid injection for coccydynia, and to determine if betamethasone or triamcinolone has the best effect.

Methods: During 2009 to 2016, we treated 277 patients with chronic coccydynia with either one 6 mg betamethasone or one 20 mg triamcinolone cortisone injection. A susequent injection was given to 62 (26%) of the patients. Read More

BMC Surg 2020 Nov 24;20(1):295. Epub 2020 Nov 24.

Department of Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.

Background: Sacrococcygeal teratomas are tumors originating from pluripotent embryonic germ cell layers located in the fetal coccyx. These tumors are highly vascular if they undergo malignant transformation. Typically, they are found in infants and children and occasionally can be diagnosed prenatally. Read More

Bone Jt Open 2020 May 12;1(5):115-120. Epub 2020 May 12.

Department of Orthopedic Surgery, St. Olavs University Hospital, Trondheim, Norway.

Aims: To determine if the results of treatment of adolescents with coccydynia are similar to those found in adults. Adult patients with coccydynia may benefit from injection therapy or operative treatment. There is little data evaluating treatment results in adolescents. Read More

Eur Spine J 2021 Apr 3;30(4):1072-1076. Epub 2020 Nov 3.

Department for Orthopaedics and Traumatology, Kepler University Hospital GmbH, Johannes Kepler University Linz, Krankenhausstrasse 9, A-4020 Linz and Altenberger Strasse 69, 4040, Linz, Austria.

Purpose: We aim to critically review the effectiveness and safety of coccygectomy with special regard to long-term outcomes.

Methods: Coccygectomy was performed in our clinic in 38 patients between 1990 and 2019. All these patients (32 females vs. Read More

Spine (Phila Pa 1976) 2020 Nov;45(22):1567-1571

Department of Orthopaedic Surgery, St. Olav's University Hospital, Trondheim, Norway.

Study Design: This is a retrospective cohort study.

Objective: To evaluate the long-term outcomes after surgery for refractory coccygodynia in patients with normal imaging studies compared with patients where imaging shows an anomaly.

Summary Of Background Data: Patients with coccydynia who do not respond to conservative treatment will often profit from coccygectomy. Read More

Indian J Radiol Imaging 2020 Apr-Jun;30(2):181-183. Epub 2020 Jul 13.

Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, United States.

Context: Focal sympathetic nerve blocks of the ganglion impar are often effective treatments for coccydynia (coccyx pain) and other pelvic pain syndromes. These injections are generally performed under contrast-enhanced fluoroscopic guidance. Vascular uptake may potentially occur during the injection and vascular uptake rates have been reported for other spinal injections, but never for ganglion impar blocks. Read More

Korean J Pain 2020 Oct;33(4):400-401

Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA.

PM R 2021 02 9;13(2):217-218. Epub 2020 Nov 9.

Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA.

Zhonghua Wei Chang Wai Ke Za Zhi 2020 May;23(5):461-465

Department of Gastrointestinal Surgery, Laboratory of Surgical Oncology, Peking University People's Hospital, Beijing 100044, China.

To investigate the clinicopathological features and prognostic factors in patients with presacral recurrent rectal cancer (PRRC). PRRC was defined as recurrence of rectal cancer after radical surgery involving posteriorly the presacral soft tissue, the sacrum/coccyx, and/or sacral nerve root. The diagnosis is confirmed with clinical symptoms (pain of pelvis/back/lower limb, bloody stools, increased frequency of defecation, and abnormal secretions), physical examination of perineal or pelvic masses, radiological findings, colonoscopy with histopathological biopsy, and the evaluation by multi-disciplinary team (MDT). Read More

Balkan Med J 2021 Jan;38(1):63

Department of Physical Medicine and Rehabilitation, Coccyx Pain Center, Rutgers New Jersey Medical School, New Jersey, United States of America.

Surg Neurol Int 2020 18;11:197. Epub 2020 Jul 18.

Department of Ortho-Spine Surgery, Sir Ganga Ram Hospital, New Delhi, India.

Background: Sacrococcygeal joint dislocation is very rare. There are seven cases of sacrococcygeal joint dislocation found in the literature; most are anterior, and only one prior case of posterior dislocation was reported involving the mid-coccygeal joint. Here, we report another case of posterior dislocation of the sacrococcygeal joint. Read More

Cureus 2020 Jun 28;12(6):e8891. Epub 2020 Jun 28.

Anesthesiology, Cleveland Clinic Fairview Hospital, Cleveland, USA.

Septic sacroiliitis is sacroiliac (SI) joint inflammation secondary to microbial invasion of the synovial space characterized by tenderness over the sacroiliac joint, difficulty walking, and lower back pain that can radiate to the buttocks. Clinicians can easily overlook septic sacroiliitis as a potential diagnosis due to its rare occurrence and non-specific symptoms. A 30-year-old female (G2P2A0) who presented acutely to the ED nine days after an uncomplicated Cesarean section performed under spinal anesthesia. Read More

Tech Coloproctol 2020 10 20;24(10):1099. Epub 2020 Jul 20.

Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, 90 Bergen St, D.O.C. Suite 3100, Newark, NJ, 07103-2425, USA.

Medicine (Baltimore) 2020 Jul;99(28):e20935

Department of Anesthesiology and Pain medicine, Chuncheon Sacred Heart Hospital, College of Medicine.

During ganglion impar block, the needle may approach the presacral space and the sacrum may be penetrated during caudal anesthesia. Because the rectum is in front of the sacrococcyx and is thus at risk for puncture, it is important to determine the distance between the sacrococcyx and rectum, as well as the thickness of the sacrococcyx.Computed tomography was used to measure the distance between the rectum and sacrococcyx, as well as the thickness of the sacrococcyx. Read More

Radiographics 2020 Jul-Aug;40(4):1090-1106

From the Department of Radiology, Palmer College of Chiropractic-West Campus, 90 E Tasman Dr, San Jose, CA 95134 (M.R.S.); Department of Radiology, Cedars-Sinai Medical Center, Los Angeles, Calif (G.R.M.); and Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, Calif (D.B.P., A.T., E.A.W., J.S.G.).

The coccygeal region has complex anatomy, much of which may contribute to or be the cause of coccyx region pain (coccydynia). This anatomy is well depicted at imaging, and management is often dictated by what structures are involved. Coccydynia is a common condition that is known to be difficult to evaluate and treat. Read More

Balkan Med J 2020 10 23;37(6):348-350. Epub 2020 Jun 23.

Department of Neurosurgery, Okan University School of Medicine, İstanbul, Turkey

Background: Coccydynia is a painful condition of the sacrococcygeal region, with symptoms associated with sitting and rising from a seated position. It is frequently related to trauma and idiopathic causes, and the pain is mostly chronic. Percutaneous vertebroplasty and sacroplasty are the methods that are widely used for treating compression fractures and sacral insufficiency fractures, respectively. Read More

Neurol Res 2020 Sep 4;42(9):789-794. Epub 2020 Jun 4.

Department of Neurosurgery, Baylor Scott & White Health, Scott and White Medical Center , Temple, TX, USA.

Objective: Performing coccygectomy procedures on patients with psychiatric disorders and/or chronic low back pain have been previously thought of as contributing factors leading to inconsistent and often poor results. To determine if these two variables affect the post-operative pain relief obtained after coccygectomy, an analysis of the opioid requirements and pain descriptions before and after surgery was undertaken in each patient studied.

Methods: The hospital electronic medical records were searched, and only patients undergoing coccygectomy for chronic coccydynia were selected. Read More

BMC Anesthesiol 2020 05 11;20(1):110. Epub 2020 May 11.

Department of Anesthesiology, Balıkesir University Health Application and Research Hospital, 10100, Balikesir, Turkey.

Background: We aimed to evaluate pain scores one year after impar ganglion block in patients with coccydynia who did not benefit from conservative treatment.

Methods: The medical records of 29 patients with coccydynia were reviewed. Patients who were referred to the algology clinic and underwent impar ganglion blocks were retrospectively evaluated. Read More

Indian J Orthop 2020 Feb 13;54(1):104. Epub 2020 Jan 13.

Rutgers New Jersey Medical School, 90 Bergen St, D.O.C. Suite 3100, Newark, NJ 07103-2425 USA.

Autops Case Rep 2020 Jan-Mar;10(1):e2019115. Epub 2019 Dec 13.

Instituto Português de Oncologia do Porto Francisco Gentil, Entidade Pública Empresarial, Surgical Oncology Service. Porto, Portugal.

Tailgut cysts (TGCs) are rare congenital entities arising from remnants of the embryological postanal primitive gut. Malignancy in TGCs is rare, with the majority being adenocarcinomas and carcinoid tumors. A search of the published literature yielded only 27 cases of adenocarcinoma developing in TGCs. Read More