Coccygeal excision for treatment of coccyx instability

Abstract

Introduction: Coccygeal excision or coccygectomy is a rare procedure for the treatment of coccygodynia. Coccygeal pain or coccygodynia, often successfully treated with conservative treatment, including steroid injection. In coccyx instability with persistent pain after failed with conservative and injection treatment, surgery is needed to remove the unstable tail bone segment. Methods: We present one case of persistent coccygeal pain in a twenty-five year old male. The patient had a history of trauma on the buttock 12 years ago, which is getting worse for the last one-year period. The patient has already undergone conservative treatment, including two episodes of steroid injection, but the pain still persists. From the lateral plain X-ray, it was found displacement on coccyx segment. Failed in conservative treatment leads to coccygeal excision. The surgical procedure was done in prone knee-chest position, and intraoperatively assessed the tailbone stability with image intensifier. Partial coccygectomy was done to this patient. Results: One month follow up showed painless tailbone, no surgical site infection, and no other complications. Conclusion: We conclude that coccygeal excision is a good treatment of choice for coccygodynia due to coccyx instability.