Atim Abdulkadir, Ergin Atilla, Bilgiç Serkan, Deniz Süleyman, Kurt Ercan
Department of Anesthesiology and Reanimation, Gülhane Military Medical Faculty, Ankara, Turkey.
Agri. 2011 Jan;23(1):1-6. doi: 10.5505/agri.2011.59002.
Coccygodynia is a clinical condition characterized by pain and tenderness around the coccygeal region. Trauma is the most common etiologic factor. We aimed to investigate the effectiveness of pulsed radiofrequency (PRF) treatment in patients with coccygodynia that could not be relieved by classic treatment protocols, and we present our long-term results with caudal epidural PRF.
The study included 21 patients who were treated for coccygodynia by caudal epidural PRF in our Pain Clinic. Sixteen patients (76%) had a history of trauma, three patients (14%) had previous surgery, and two patients (10%) had idiopathic coccygodynia with no identifiable cause. All patients had been previously treated with conservative methods, but none had pain relief. Pain level of the patients was assessed by visual analog scale (VAS) score. A questionnaire to evaluate subjective patient satisfaction was also used at the 3rd-week and the 6th-month follow-ups.
Median VAS score was 8 at baseline, decreased to 2 by the 3rd week and was 2 at the 6th month. VAS at the 3rd week and 6th month were significantly lower compared to baseline (p<0.001). At the 6th month, 12 patients (57%) had excellent results, 5 patients (24%) had good results and only 4 patients (19%) had poor results regarding the subjective patient satisfaction questionnaire.
Caudal epidural PRF may be an alternative to surgery for coccygodynia patients who are unresponsive to classic treatment methods.
尾骨痛是一种以尾骨区域疼痛和压痛为特征的临床病症。创伤是最常见的病因。我们旨在研究脉冲射频（PRF）治疗对经传统治疗方案无法缓解的尾骨痛患者的有效性，并展示我们采用骶管硬膜外PRF的长期治疗结果。
本研究纳入了21例在我们疼痛诊所接受骶管硬膜外PRF治疗尾骨痛的患者。16例患者（76%）有创伤史，3例患者（14%）曾接受过手术，2例患者（10%）患有特发性尾骨痛，病因不明。所有患者此前均接受过保守治疗，但均未缓解疼痛。通过视觉模拟量表（VAS）评分评估患者的疼痛程度。在第3周和第6个月随访时还使用了一份评估患者主观满意度的问卷。
基线时VAS评分中位数为8分，第3周降至2分，第6个月时仍为2分。第3周和第6个月时的VAS评分与基线相比显著降低（p<0.001）。在第6个月时，根据患者主观满意度问卷，12例患者（57%）效果极佳，5例患者（24%）效果良好，只有4例患者（19%）效果较差。
对于对传统治疗方法无反应的尾骨痛患者，骶管硬膜外PRF可能是一种手术替代方案。
