title: Instability of the coccyx in coccydynia.
abstract: 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.
authors.affiliation: Department of Physical Medicine, Hôtel-Dieu University Hospital, Place du Parvis Notre-Dame, Paris, France.
authors.forename: J Y
authors.initials: JY
authors.lastname: Maigne
authors.forename: D
authors.initials: D
authors.lastname: Lagauche
authors.forename: L
authors.initials: L
authors.lastname: Doursounian
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003050:Coccyx / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000000981:diagnostic imaging / Q000601:surgery; D018579:Patient Selection; D011446:Prospective Studies; D011859:Radiography; D013122:Spinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome