The Journal of Bone and Joint Surgery, Vol 65, Issue 8 1116-1124, Copyright © 1983 by Journal of Bone and Joint Surgery, Inc
Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx
F Postacchini and M Massobrio
We studied the normal radiographic anatomy of the coccyx in 120
asymptomatic subjects and performed a retrospective review of the results
in fifty-one patients who had had a partial or total coccygectomy for
idiopathic coccygodynia during a twenty-year period. Of the asymptomatic
subjects, the sacrococcygeal joint was fused in forty-four (37 per cent);
the first intercoccygeal joint, in twelve (10 per cent); and the second
intercoccygeal joint, in fifty-two (43 per cent). Four types of
configuration of the coccyx were identified on the lateral radiographs. In
Type I the coccyx was curved slightly forward, whereas in Type II the curve
of the coccyx, which pointed straight forward, was more marked. In Type III
the coccyx was angulated forward sharply, and in Type IV it was subluxated
at the sacrococcygeal or the intercoccygeal joint. Most subjects (68 per
cent) had a Type-I configuration. Of the fifty-one patients with idiopathic
coccygodynia, twenty-six (51 per cent) showed fusion of the sacrococcygeal
joint; six (12 per cent), of the first intercoccygeal joint; and
twenty-five (49 per cent), of the second intercoccygeal joint. In most
patients (69 per cent) the coccyx had a Type-II, III, or IV configuration.
Thirty-one patients had undergone a partial coccygectomy and twelve, a
total coccygectomy; in the remaining eight patients the extent of the
coccygectomy could not be determined. The results of surgery were excellent
or good in thirty-two (88 per cent) of the thirty-six patients who were
followed for at least two years.(ABSTRACT TRUNCATED AT 250 WORDS)