Objective: Coccydynia is a condition characterized by pain and tenderness in and around the coccyx. This study compares characteristics of conservatively treated versus surgically treated patients. Data was collected on gender, age at onset, age at diagnosis, body mass index, symptom duration, etiology, presenting symptoms,radiographic appearance, and treatment modalities of patients with coccydynia treated conservatively from 1998 to 2003 versus coccydynia treated surgically via coccygectomy. Patient population is from an HMO in the Puget Sound region of Washington. This study further assesses patient satisfaction with results of coccygectomy.
Methods: Part I of this study is a retrospective chart and radiograph analysis of 26 conservatively treated patients and 12 consecutive surgically treated patients from Group Health Cooperative of Puget Sound. Part II of this study is a quality of life assessment via phone interview of 10 surgically treated patients from Group Health Cooperative of Puget Sound.
Results: Part I: The differences in patient characteristics of non-surgical versus surgical patients are not statistically significant. The notable proportional differences between groups are: the non-surgical group has a high instance of females versus males, pain symptoms for 38% more time before diagnosis; the surgical group has idiopathic determination by 2X or more than the other etiologies, "C Extreme" configuration xray results over 40%, 92% "abnormal" BMI, and steroid injection in coccygeal region proportionally high at 100%.
For Part II: The observed averages show a high instance of females versus males in surgical patients. The average relief of pain from coccygectomy surgery was great at 8/10. The average amount of time until relief of their pain symptoms was 5 months. There were no surgical complications in 70% of patients. Delayed wound healing presented in 20% of patients. Site infection occurred in 10% of patients. All 10 patients said they would refer a friend for the same surgery if he/she had similar symptoms.
Conclusion: This study is limited statistically by small sampling. However, the proportional differences among non-surgical and surgical patients make the findings worth noting. This study suggests that coccyges with "C Extreme" configuration and "abnormal" BMI may be more likely to progress to surgical treatment. With 100% of patients receiving surgery showing improvement and. only minimal healing complications, coccygectomy appears be a safe and effective surgery for the relief of coccydynia when conservative treatment has failed.
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