Posttraumatic coccygeal instability

Mouhsine, Elyazid; Garofalo, Raffaele; Chevalley, François; Moretti, Biagio; Theumann, Nicolas; Borens, Olivier; Maffulli, Nicola; Schizas, Constantin; Wettstein, Michael

doi:10.1016/j.spinee.2005.12.004

« Previous Next »The Spine Journal
Volume 6, Issue 5 , Pages 544-549, September 2006

Posttraumatic coccygeal instability

Elyazid Mouhsine, MD
- Orthopaedics and Trauma Department, University Hospital, 1011 Lausanne, Switzerland
- Corresponding author. Associate Professor, Orthopaedics and Trauma Department, University Hospital, CHUV BH-14, CH-1011 Lausanne, Switzerland. Tel.: 00 41 21 314 27 91; fax: 00 41 21 314 28 00.
Raffaele Garofalo, MD
- Orthopaedics and Trauma Department, University Hospital, 1011 Lausanne, Switzerland
François Chevalley, MD
- Orthopaedics and Trauma Department, University Hospital, 1011 Lausanne, Switzerland
Biagio Moretti, MD
- Department of Clinical Methodology and Surgical Technique, Orthopedics Section II, University of Bari, Bari, Italy
Nicolas Theumann, MD
- Department of Radiology, University Hospital, 1011 Lausanne, Switzerland
Olivier Borens, MD
- Orthopaedics and Trauma Department, University Hospital, 1011 Lausanne, Switzerland
Nicola Maffulli, MD
- Department of Trauma and Orthopaedic Surgery, Keele University, School of Medicine, Stoke on Trent, Staffordshire, ST5 5BG, United Kingdom
Constantin Schizas, MD
- Orthopaedics and Trauma Department, University Hospital, 1011 Lausanne, Switzerland
Michael Wettstein, MD
- Orthopaedics and Trauma Department, University Hospital, 1011 Lausanne, Switzerland

Received 7 June 2005; accepted 10 December 2005. published online 27 July 2006.

Abstract

Purpose

To report the middle term results of partial coccygectomy in a consecutive series of 15 patients with chronic coccygodynia.

Methods

Fifteen patients with chronic coccygodynia were referred to our outpatient clinics. The patients were investigated with dynamic lateral radiography and magnetic resonance imaging (MRI). We diagnosed a posttraumatic coccygodynia with instability of the coccygeal segment and performed a partial coccygectomy after failure of the conservative treatment.

Results

All patients underwent subjective and objective assessment after a mean time of 2.8 years from surgery. There were 11 excellent, 3 good, and 1 fair results. The mean time of improvement was 15 weeks, and no further improvement was observed after 6 months.

Conclusion

Partial coccygectomy is a good therapeutic option for posttraumatic coccygodynia. Dynamic radiography is a useful tool to differentiate posttraumatic from idiopathic coccygodynia. MRI may be useful for further evaluation of the patients after inconclusive dynamic radiography.

Keywords: Trauma, Chronic, Coccygodynia, Surgery