title: Treatment principles for coccygodynia.
abstract: OBJECTIVE
  An evaluation of treatment methods and outcomes for coccygodynia cases that do not respond to conservative treatment.
  
  
  METHODS
  Local anesthetic and steroid injections were applied in 32 coccygodynia cases that did not respond to conservative treatment (average of 15 months). Coccyx excision was performed as surgical treatment in 25 cases that had pain relief after the injections but later re-presented with complaints. The patients' pain levels were assessed with VAS. Postacchini classification was used for patient classification based on plain radiography.
  
  
  RESULTS
  20 (62%) of the cases (the total including injection and surgery groups) had a trauma history. Majority of the cases treated with local steroid injection included patients with Type I, while the 25 cases that received surgical treatment predominantly included Type II patients. One case had post-operative skin infection, which was treated with antibiotics. It was observed by comparing pre-operative and post-operative pain scores that both methods provided significant pain relief in all patients.
  
  
  CONCLUSIONS
  While local steroid injection is an effective method of treatment for Type I patients, the coccyx removal is an effective method for controlling the pain in patients with trauma history and in Type II, III and IV patients.
authors: Neurospinal Academy, Istanbul, Turkey.
authors: Sedat
authors: S
authors: Dalbayrak
authors: Onur
authors: O
authors: Yaman
authors: Tevfik
authors: T
authors: Yilmaz
authors: Mesut
authors: M
authors: Yilmaz
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003050:Coccyx / Q000601:surgery*; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000601:surgery* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010147:Pain Measurement; D012008:Recurrence; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D000893:Anti-Inflammatory Agents; D013256:Steroids