Maigne J Y, Lagauche D, Doursounian L
Department of Physical Medicine, Hôtel-Dieu University Hospital, Place du Parvis Notre-Dame, Paris, France.
J Bone Joint Surg Br. 2000 Sep;82(7):1038-41. doi: 10.1302/0301-620x.82b7.10596.
Coccygectomy is a controversial operation. Some authors have reported good results, but others advise against the procedure. The criteria for selection are ill-defined. We describe a study to validate an objective criterion for patient selection, namely radiological instability of the coccyx as judged by intermittent subluxation or hypermobility seen on lateral dynamic radiographs when sitting. We enrolled prospectively 37 patients with chronic pain because of coccygeal instability unrelieved by conservative treatment who were not involved in litigation. The operation was performed by the same surgeon. Patients were followed up for a minimum of two years after coccygectomy, with independent assessment at two years. There were 23 excellent, 11 good and three poor results. The mean time to definitive improvement was four to eight months. Coccygectomy gave good results in this group of patients.
尾骨切除术是一种存在争议的手术。一些作者报告了良好的效果，但另一些人则不建议进行该手术。选择标准尚不明确。我们描述了一项研究，以验证一种客观的患者选择标准，即通过坐位时侧位动态X线片上出现的间歇性半脱位或活动过度来判断尾骨的放射学不稳定。我们前瞻性地纳入了37例因尾骨不稳定导致慢性疼痛且经保守治疗无效且未涉及诉讼的患者。手术由同一位外科医生进行。尾骨切除术后，患者至少随访两年，并在两年时进行独立评估。结果为23例优、11例良和3例差。最终改善的平均时间为4至8个月。在这组患者中，尾骨切除术取得了良好的效果。
