Department of Orthopedics and Trauma Surgery, Fondazione Casa Sollievo Della Sofferenza IRCCS, 71013, San Giovanni Rotondo, Italy.
Department of Orthopedics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
Int Orthop. 2024 Aug;48(8):2251-2258. doi: 10.1007/s00264-024-06236-y. Epub 2024 Jun 18.
Coccydynia, characterized by persistent pain in the coccygeal region, significantly impacts patients' quality of life. While various treatment modalities exist, including conservative measures and surgical interventions like coccygectomy, optimal management remains unclear. This retrospective cohort study aimed to compare the clinical outcomes, functional improvements, and quality of life in patients with chronic coccydynia undergoing either infiltrative treatment or coccygectomy.
Data from patients treated at our institution from January 2018 to December 2022 were analyzed. Participants meeting inclusion criteria were divided into two groups: Group A underwent coccygectomy, while Group B received conservative therapy. Clinical assessments, radiographic evaluations, and patient-reported outcomes were collected preoperatively and at follow-up intervals.
Of the 223 initially examined patients, 55 met inclusion criteria. Group A (n = 21) underwent coccygectomy, while Group B (n = 34) received conservative therapy. Both groups showed significant pain reduction post-intervention, with sustained improvement in Group A. Functional outcomes favoured Group A, with significant improvements in disability and quality of life measures. Complications were minimal, with only one case of superficial wound infection in Group A.
Our findings suggest that coccygectomy provides superior and lasting pain relief, functional improvement, and quality of life improvement compared to conservative therapy. While complications were minimal, further research with larger cohorts is warranted to validate these results and explore long-term outcomes. Despite its historical association with complications, advancements in surgical techniques and perioperative care have led to improved outcomes and reduced complication rates. Thus, coccygectomy should be considered in the treatment algorithm for patients with debilitating coccydynia.
尾痛症的特征是尾骨区域持续疼痛，显著影响患者的生活质量。虽然存在多种治疗方式，包括保守治疗和手术干预如尾骨切除术，但最佳治疗方法仍不明确。本回顾性队列研究旨在比较慢性尾痛症患者接受浸润治疗或尾骨切除术的临床结局、功能改善和生活质量。
分析了 2018 年 1 月至 2022 年 12 月在我院接受治疗的患者数据。符合纳入标准的参与者被分为两组：A 组接受尾骨切除术，B 组接受保守治疗。在术前和随访期间收集临床评估、影像学评估和患者报告的结果。
在最初检查的 223 名患者中，有 55 名符合纳入标准。A 组（n=21）接受尾骨切除术，B 组（n=34）接受保守治疗。两组患者干预后疼痛均显著减轻，A 组疼痛持续改善。功能结局方面，A 组更优，残疾和生活质量测量指标均显著改善。并发症较少，A 组仅 1 例出现浅表伤口感染。
我们的研究结果表明，与保守治疗相比，尾骨切除术能提供更优、更持久的疼痛缓解、功能改善和生活质量提高。尽管存在并发症，但手术技术和围手术期护理的进步已导致结局改善和并发症发生率降低。因此，对于患有严重尾痛症的患者，尾骨切除术应纳入治疗方案中。
