title: Radiofrequency Ablation in Coccydynia: A Case Series and Comprehensive, Evidence-Based Review.
abstract: Coccydynia is a condition with a multitude of different causes, characterized by ill-defined management. There are multiple prospective studies, including several controlled trials, that have evaluated conservative therapies. Additionally, a plethora of observational studies have assessed coccygectomy, but few studies have reported results for nonsurgical interventional procedures. In this report, we describe the treatment results of 12 patients who received conventional or pulsed radiofrequency for coccydynia and systematically review the literature on management.
  
  
  
  We performed a retrospective data analysis evaluating patients who underwent pulsed or conventional radiofrequency treatment at Johns Hopkins Hospital and Walter Reed National Military Medical Center. A comprehensive literature review was also performed to contextualize these results.
  
  
  
  The mean age of patients treated was 50.25 years (SD = 11.20 years, range = 32-72 years), with the mean duration of symptoms being 3.6 years (SD = 3.36 years, range 1-10 years). There were 10 males and two females in this cohort. Among patients who received radiofrequency treatment, the average benefit was 55.5% pain relief (SD = 30.33%, range = 0-100%). Those who underwent conventional (vs pulsed radiofrequency) and who received prognostic blocks were more likely to experience a positive outcome. There were two cases of neuritis, which resolved spontaneously after several weeks.
  
  
  
  Radiofrequency ablation of the sacrococcygeal nerves may serve as a useful treatment option for patients with coccydynia who have failed more conservative measures. Further research into this therapeutic approach and its benefit for coccydynia should incorporate a control group for comparison.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.
authors.forename: Yian
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology and Interventional Pain Medicine, Greenwich Anesthesiology Associates, Greenwich Hospital, Yale University, New Haven, Connecticut.
authors.forename: Julie H Y
authors.initials: JHY
authors.lastname: Huang-Lionnet
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.|Neurology and Physical Medicine & Rehabilitation, Departments of Anesthesiology and Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Cohen
mesh_terms: D001416:Back Pain / Q000000981:diagnostic imaging* / Q000628:therapy; D017115:Catheter Ablation / Q000379:methods*; D003050:Coccyx / Q000000981:diagnostic imaging*; D019317:Evidence-Based Medicine; D006801:Humans; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012189:Retrospective Studies