1514. Coccydynia: Favorable Prognosticators for Success of Coccygectomy

Authors: Brian Patrick Curry, MD; Nicholas Szuflita, MD; Christopher Neal, MD; George Rymarczuk, MD (Bethesda, MD)

Introduction:

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.

Methods:

The authors report two patients with favorable outcomes after surgical management of coccydynia, and suggest factors that may portend a positive response to coccygectomy.

Results:

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.

Conclusion:

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.