Surgical treatment strategy in patients suffering from post-traumatic coccygodynia

Abstract

Clinical effectiveness of coccus removal in post-traumatic coccigodinia is evaluated. The study included 34 patients with diagnosed post-traumatic coccigodinia who underwent surgical treatment in resection or coccyx removal volume. A long history of trauma-related pain syndrome and ineffective conservative treatment were noted in all patients. The exclusion criteria were: inflammatory or oncological process, chronic urogenital diseases, previously undergoing operations on the lumbosacral spine, complicated by the course of the hernia of the intervertebral disc with root syndrome and neurological disorders. Before the operation, patients underwent manual examination, radiography (in direct and lateral projections) and computed tomography of the sacrum and coccyx, examination of the gynecologist (for women) and urologist (for men), examination of the proctologist, according to the indications magnetic resonance imaging of the spine in order to exclude hernia of the intervertebral disc with neural compression and dermoid cysts of the copcystic. Evaluation of treatment results was performed using a visual analogue pain scale and a verbal 5-point operation satisfaction scale. The observation period was from 1 year to 4 years. Cupping of pain syndrome after surgery was noted in 28 (82.4%) cases, in 6 (17.6%) patients there was a decrease in the intensity of pain syndrome with discomfort only after a prolonged sitting position. 5 (14.7%) patients were "satisfied" with surgery, 28 (82.4%) patients were "completely satisfied", in one (2.9%) case there was "doubtful satisfaction" with surgery. Thus, surgical treatment of coccigodinia in the volume of partial or complete coccyx removal is indicated in cases of ineffectiveness of conservative treatment in its post-traumatic instability. Surgical intervention leads to the cessation of pain syndrome and allows patients to return to their previous physical activity.