PMID- 27037436
OWN - NLM
STAT- MEDLINE
DCOM- 20160830
LR  - 20160402
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 98-B
IP  - 4
DP  - 2016 Apr
TI  - Coccygectomy for patients with chronic coccydynia: a prospective, observational 
      study of 98 patients.
PG  - 526-33
LID - 10.1302/0301-620X.98B4.36641 [doi]
AB  - AIMS: The purpose of this prospective study was to evaluate the outcomes of 
      coccygectomy for patients with chronic coccydynia. PATIENTS AND METHODS: Between 
      2007 and 2011, 98 patients underwent coccygectomy for chronic coccydynia. The 
      patients were aged > 18 years, had coccygeal pain, local tenderness and a 
      radiological abnormality, and had failed conservative management. Outcome 
      measures were the Short Form 36 (SF-36), the Oswestry Disability Index (ODI) and 
      a visual analogue scale (VAS) for pain. Secondary analysis compared the 
      pre-operative features and the outcomes of patients with successful and failed 
      treatment, two years post-operatively. The threshold for success was based on a 
      minimum clinically important difference (MCID) on the ODI of 20 points. All other 
      patients, including those lost to follow-up, were classified as failures. 
      RESULTS: There was significant improvement in all ten components of the SF-36 (p 
      < 0.05), the ODI (23 points) and VAS (39 points) (p < 0.0001). A total of 69 
      patients (70.4%) met the designated MCID threshold for a successful outcome. The 
      failure group consisted of 25 patients (25.5%) who did not reach the MCID and 
      four (4.1%) who were lost to follow-up. Six patients (6.1%) in the failure group 
      had ODI scores that were no better or worse than that pre-operatively. The 
      patients in whom treatment failed had significantly worse pre-operative scores 
      for the ODI (p = 0.04), VAS (p = 0.02) and on five of ten SF-36 components (p < 
      0.04). They also had a higher incidence of psychiatric disorders, pre-operative 
      opiate use and more than three comorbidities. TAKE HOME MESSAGE: Coccygectomy for 
      chronic coccydynia results in significant improvement in patient-reported 
      outcomes at two years. Failure is associated with certain pre-operative 
      characteristics such as psychiatric illness, poor quality of life features, 
      higher levels of pain, and use of opiates.
CI  - (c)2016 The British Editorial Society of Bone & Joint Surgery.
FAU - Hanley, E N
AU  - Hanley EN
AD  - Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300 Charlotte, NC 
      28204, USA.
FAU - Ode, G
AU  - Ode G
AD  - Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300 Charlotte, NC 
      28204, USA.
FAU - Jackson Iii, B J
AU  - Jackson Iii BJ
AD  - University of South Carolina, 2 Medical Park, Columbia, SC 29203, USA.
FAU - Seymour, R
AU  - Seymour R
AD  - Carolinas Medical Center, 1025 Morehead Medical Drive, Suite 300 Charlotte, NC 
      28204, USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - IM
MH  - Adult
MH  - Aged
MH  - Back Pain/rehabilitation/*surgery
MH  - Chronic Disease
MH  - *Disability Evaluation
MH  - Female
MH  - Humans
MH  - Lumbar Vertebrae
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Patient Satisfaction
MH  - Prospective Studies
MH  - Quality of Life
MH  - Sacrococcygeal Region
MH  - Spinal Fusion/*adverse effects
MH  - Treatment Outcome
MH  - Young Adult
OTO - NOTNLM
OT  - Coccydynia; coccygectomy; coccyx; sacrococcygeal injection
EDAT- 2016/04/03 06:00
MHDA- 2016/08/31 06:00
CRDT- 2016/04/03 06:00
PHST- 2015/06/04 00:00 [received]
PHST- 2015/11/02 00:00 [accepted]
PHST- 2016/04/03 06:00 [entrez]
PHST- 2016/04/03 06:00 [pubmed]
PHST- 2016/08/31 06:00 [medline]
AID - 98-B/4/526 [pii]
AID - 10.1302/0301-620X.98B4.36641 [doi]
PST - ppublish
SO  - Bone Joint J. 2016 Apr;98-B(4):526-33. doi: 10.1302/0301-620X.98B4.36641.