创伤性尾骨痛患者行尾骨切除术的获益多于非创伤性病因行尾骨切除术的患者。

Traumatic coccydynia patients benefit from coccygectomy more than patients undergoing coccygectomy for non-traumatic causes.

机构信息

Orthopaedic Department, Washington University School of Medicine, Saint Louis, MO, USA.

Department of Orthopedics and Traumatology, Bezmialem Vakif University School of Medicine, Fatih, Istanbul, Turkey.

出版信息

J Orthop Surg Res. 2023 Oct 27;18(1):802. doi: 10.1186/s13018-023-04098-5.

DOI:10.1186/s13018-023-04098-5

PMID:37891674

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10605957/

Abstract

PURPOSE

Conservative treatment is the first step in the management of coccydynia. However, surgical treatment is required in cases where conservative treatment fails. The aim of this study was to compare the effect of traumatic and atraumatic etiologies on functional outcomes in patients who underwent coccygectomy for chronic coccydynia.

METHODS

Ninety-seven patients who underwent partial coccygectomy between October 2010 and December 2018 for the diagnosis of chronic coccygodynia were evaluated retrospectively. The patients were divided into two groups according to etiologies as atraumatic (group AT) and traumatic (group T). Concomitant disorders of the patients were recorded as psychiatric and musculoskeletal diseases. Visual Analog Scale (VAS) for low back pain, the Oswestry Disability Index (ODI) scale, Short Form-36 Physical Component Summary and Short Form-36 Mental Component Summary were used to evaluate the clinical outcomes pre- and postoperative at the last follow-up.

RESULTS

The mean follow-up time was 67.3 ± 13.9 (range; 44-115) months. Group AT and group T included 48 (mean age 37.1 ± 11.3 and 36 (75%) female) and 49 patients (mean age 36 ± 11 and 35 (71.4%) female), respectively. The groups were statistically similar in terms of age (p = 0.614), gender (p = 0.691), body mass index (p = 0.885), tobacco usage (p = 0.603) and duration of pain (p = 0.073). However, the rate of musculoskeletal and total concomitant disorders was higher in the Group AT than in Group T (p < 0.05). The average preoperative SF-36 MCS and SF-36 PCS scores improved at the last follow-up from 43.3 ± 6.2 and 35.6 ± 4.9 to 72 ± 14.1 and 58.3 ± 10.9, respectively. The preoperative VAS and ODI decreased from 8 ± 1.4 and 39.8 ± 8.5 to 2.6 ± 1.8 and 13.4 ± 8.9 at the last follow-up, respectively.

CONCLUSION

Successful results were obtained with surgical treatment in chronic coccygodynia. In addition, functional outcomes in patients with traumatic etiology are better than in atraumatic ones. Levels of evidence Level III; Retrospective Comparative Study.

摘要

目的

在尾痛症的治疗中，保守治疗是第一步。然而，如果保守治疗失败，则需要手术治疗。本研究的目的是比较创伤性和非创伤性病因对慢性尾痛症患者行尾骨切除术的功能结果的影响。

方法

回顾性分析 2010 年 10 月至 2018 年 12 月期间因慢性尾痛症行部分尾骨切除术的 97 例患者。根据病因将患者分为非创伤性（组 AT）和创伤性（组 T）两组。记录患者的合并症为精神和骨骼肌肉疾病。术前和末次随访时使用视觉模拟量表（VAS）评估下腰痛、Oswestry 残疾指数（ODI）量表、36 项简明健康状况量表（SF-36）躯体成分摘要和 36 项简明健康状况量表（SF-36）心理成分摘要评估临床结果。

结果

平均随访时间为 67.3±13.9（范围：44-115）个月。组 AT 和组 T 分别包括 48 例（平均年龄 37.1±11.3 岁和 49 例（75%女性））和 49 例患者（平均年龄 36±11 岁和 35 例（71.4%女性））。两组在年龄（p=0.614）、性别（p=0.691）、体重指数（p=0.885）、吸烟（p=0.603）和疼痛持续时间（p=0.073）方面无统计学差异。然而，组 AT 的骨骼肌肉和总合并症的发生率高于组 T（p<0.05）。末次随访时，SF-36 MCS 和 SF-36 PCS 平均评分从术前的 43.3±6.2 和 35.6±4.9 分别改善至 72±14.1 和 58.3±10.9。术前 VAS 和 ODI 分别从 8±1.4 和 39.8±8.5 降至 2.6±1.8 和 13.4±8.9。