Coccygectomy for refractory coccydynia, old-fashioned but effective procedure: A retrospective analysis.

Autor: Perna A; 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., Franchini A; Department of Orthopedics and Trauma Surgery, Fondazione Casa Sollievo Della Sofferenza IRCCS, 71013, San Giovanni Rotondo, Italy., Macchiarola L; Department of Orthopedics and Trauma Surgery, Fondazione Casa Sollievo Della Sofferenza IRCCS, 71013, San Giovanni Rotondo, Italy., Maruccia F; Department of Orthopedics and Trauma Surgery, Fondazione Casa Sollievo Della Sofferenza IRCCS, 71013, San Giovanni Rotondo, Italy., Barletta F; Department of Orthopedics and Trauma Surgery, Fondazione Casa Sollievo Della Sofferenza IRCCS, 71013, San Giovanni Rotondo, Italy., Bosco F; Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy., Rovere G; Department of Orthopedics, Università Cattolica del Sacro Cuore, 00168, Rome, Italy. giuseppe.rovere02@icatt.it.; Clinical Science and Translational Medicine, Section of Orthopaedics and Traumatology, University of Rome Tor Vergata, 00133, Rome, Italy. giuseppe.rovere02@icatt.it., Gorgoglione FL; Department of Orthopedics and Trauma Surgery, Fondazione Casa Sollievo Della Sofferenza IRCCS, 71013, San Giovanni Rotondo, Italy.
Jazyk: angličtina
Zdroj: International orthopaedics [Int Orthop] 2024 Aug; Vol. 48 (8), pp. 2251-2258. Date of Electronic Publication: 2024 Jun 18.
DOI: 10.1007/s00264-024-06236-y
Abstrakt: Purpose: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
(© 2024. The Author(s).)
Databáze: MEDLINE
Externí odkaz: