1514. Coccydynia: Favorable Prognosticators for Success of Coccygectomy
Authors: Brian Patrick Curry, MD; Nicholas Szuflita, MD; Christopher Neal, MD; George Rymarczuk, MD (Bethesda, MD)
Indications for surgical management of coccydynia are not well-defined in the medical literature. Furthermore, relatively high rates of local wound infection make coccygectomy a controversial procedure.
The authors report two patients with favorable outcomes after surgical management of coccydynia, and suggest factors that may portend a positive response to coccygectomy.
The first patient suffered a pathologic coccygeal fracture from metastatic disease. The second presented with a displaced, mobile, chronic coccygeal fracture; this patient had derived significant but temporary benefit from focal injections performed by the Anesthesia Pain service. Both patients underwent coccygectomy and experienced excellent symptomatic relief postoperatively.
The presence of imaging abnormalities of the coccyx, such as pathologic fractures and chronic non-union, and a positive response to focal injections are factors that likely predict a good outcome following coccygectomy.