Lin Chien-Hung, Wu Szu-Ying, Hu Wen-Long, Hung Chia-Hung, Hung Yu-Chiang, Aurea Kuo Chun-En
Department of Traditional Medicine, Kaohsiung Chang Gung Memorial Hospital.
Department of Sports Medicine.
Medicine (Baltimore). 2020 Feb;99(6):e18860. doi: 10.1097/MD.0000000000018860.
Coccyx fracture is an injury usually caused by trauma. In most cases, the fractures recover after conservative therapy. For refractory cases that exhibit coccydynia after more than 2 months of conservative treatment, coccygectomy is indicated. However, limited information about the efficacy of this procedure is available, and it is known to have a high complication rate. As such, other therapeutic approaches are needed. Here, we report our experience using another conservative treatment option, low-level laser therapy, to successfully reduce refractory coccydynia in a patient with coccyx fracture.
A 23-year-old woman had refractory coccydynia and increased pain after a traffic accident-induced coccyx fracture.
Initially, the patient reported transient improvement after conservative treatment with non-steroidal anti-inflammatory drugs. However, the pain increased in severity (numerical rating scale score of 8) soon after she resumed work in her office, and progressed in the following 2 months. Surgical intervention was suggested owing to the prolonged coccydynia following the failure of conservative treatment and difficulties in performing daily life activities. However, she sought other conservative therapy options, because she was concerned about the risks associated with the coccygectomy surgery.
The patient received low-level laser therapy once a week, for 24 weeks.
After 11 weeks of treatment, the patient reported significant improvements in her symptoms; her pain was reduced to a numerical rating scale score of 2 and bone healing was noted on radiographs. The patient could eventually perform her daily activities satisfactorily, without coccydynia, after 24 weeks of treatment.
Laser acupuncture produced analgesic effects in this patient with refractory coccydynia after traumatic coccyx fracture. This is the first case report to apply laser acupuncture for refractory coccydynia after traumatic coccyx fracture. Our findings imply that laser acupuncture may be a good conservative therapy option for coccyx fracture.
尾骨骨折是一种通常由外伤引起的损伤。在大多数情况下，骨折经保守治疗后可恢复。对于保守治疗2个月以上仍出现尾骨痛的难治性病例，建议行尾骨切除术。然而，关于该手术疗效的信息有限，且已知其并发症发生率高。因此，需要其他治疗方法。在此，我们报告我们使用另一种保守治疗选择——低强度激光治疗，成功减轻一名尾骨骨折患者难治性尾骨痛的经验。
一名23岁女性在交通事故导致尾骨骨折后出现难治性尾骨痛且疼痛加剧。
最初，患者报告在使用非甾体抗炎药进行保守治疗后有短暂改善。然而，她恢复办公室工作后不久，疼痛严重程度增加（数字评分量表评分为8分），并在接下来的2个月内逐渐加重。由于保守治疗失败后尾骨痛持续时间延长且日常生活活动困难，建议进行手术干预。然而，她寻求其他保守治疗选择，因为她担心尾骨切除手术的风险。
患者每周接受一次低强度激光治疗，共24周。
治疗11周后，患者报告症状有显著改善；疼痛减轻至数字评分量表评分为2分，X线片显示有骨愈合。治疗24周后，患者最终能够满意地进行日常活动，且无尾骨痛。
激光针刺对该外伤性尾骨骨折后难治性尾骨痛患者产生了镇痛效果。这是首例应用激光针刺治疗外伤性尾骨骨折后难治性尾骨痛的病例报告。我们的研究结果表明，激光针刺可能是尾骨骨折的一种良好保守治疗选择。
