Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical Note
Objective There is a growing body of clinical evidence to support coccygectomy as an effective treatment for chronic coccygodynia. To date, the authors identified no other studies that describe and evaluate the paramedian surgical approach to coccygectomy and post-operative outcomes. Methods A case...
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| Format: | Article |
| Language: | English |
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Korean Minimally Invasive Spine Surgery Society
2020-10-01
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| Series: | Journal of Minimally Invasive Spine Surgery and Technique |
| Subjects: | |
| Online Access: | http://www.jmisst.org/upload/pdf/jmisst-2020-00143.pdf |
| _version_ | 1797951512592252928 |
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| author | Kyle Geiger Carson Fuller Crystal Gomez Miguel A. Schmitz |
| author_facet | Kyle Geiger Carson Fuller Crystal Gomez Miguel A. Schmitz |
| author_sort | Kyle Geiger |
| collection | DOAJ |
| description | Objective There is a growing body of clinical evidence to support coccygectomy as an effective treatment for chronic coccygodynia. To date, the authors identified no other studies that describe and evaluate the paramedian surgical approach to coccygectomy and post-operative outcomes. Methods A case report of 36 patients who underwent coccygectomy with a paramedian or midline approach. All patients had chronic coccydynia that was refractory to conservative treatment. Three patients were excluded from the study due to additional lumbar surgery (2) or missing data (1). Outcomes assessed were Visual Analog Scale (VAS), operative and post-operative complications, use of post-operative pain medication, and surgery time. Results Included in the study were 24 females and 9 males with a mean age of 46 years (range 18-74 years). The most common etiologies were trauma (26) and idiopathic (7). Twenty seven patients underwent coccygectomy with a paramedian approach and 6 had the same procedure with the midline incision. There was a significantly lower infection rate in the paramedian group (p-value=0.00871). Conclusion The paramedian and midline approach to coccygectomy are both viable treatments for coccygodynia. The two methods offer low complication rates and high patient satisfaction. Surgeon and patient preference should be taken into account when choosing a surgical approach for coccygectomy. Further examination comparing traditional midline vs. paramedian approach are needed to assess superiority. |
| first_indexed | 2024-04-10T22:31:48Z |
| format | Article |
| id | doaj.art-50a970420aec49e7959443f83fb24283 |
| institution | Directory Open Access Journal |
| issn | 2508-2043 |
| language | English |
| last_indexed | 2024-04-10T22:31:48Z |
| publishDate | 2020-10-01 |
| publisher | Korean Minimally Invasive Spine Surgery Society |
| record_format | Article |
| series | Journal of Minimally Invasive Spine Surgery and Technique |
| spelling | doaj.art-50a970420aec49e7959443f83fb242832023-01-17T04:30:59ZengKorean Minimally Invasive Spine Surgery SocietyJournal of Minimally Invasive Spine Surgery and Technique2508-20432020-10-0152646810.21182/jmisst.2020.0014373Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical NoteKyle Geiger0Carson Fuller1Crystal Gomez2Miguel A. Schmitz3 Department of Orthopaedics, Washington State University, Elson S. Floyd College of Medicine, Spokane, WA, U.S.A. Department of Orthopaedics, Washington State University, Elson S. Floyd College of Medicine, Spokane, WA, U.S.A. Department of Orthopaedics, Alpine Orthopaedic and Spine, Spokane, WA, U.S.A. Department of Orthopaedics, Washington State University, Elson S. Floyd College of Medicine, Spokane, WA, U.S.A.Objective There is a growing body of clinical evidence to support coccygectomy as an effective treatment for chronic coccygodynia. To date, the authors identified no other studies that describe and evaluate the paramedian surgical approach to coccygectomy and post-operative outcomes. Methods A case report of 36 patients who underwent coccygectomy with a paramedian or midline approach. All patients had chronic coccydynia that was refractory to conservative treatment. Three patients were excluded from the study due to additional lumbar surgery (2) or missing data (1). Outcomes assessed were Visual Analog Scale (VAS), operative and post-operative complications, use of post-operative pain medication, and surgery time. Results Included in the study were 24 females and 9 males with a mean age of 46 years (range 18-74 years). The most common etiologies were trauma (26) and idiopathic (7). Twenty seven patients underwent coccygectomy with a paramedian approach and 6 had the same procedure with the midline incision. There was a significantly lower infection rate in the paramedian group (p-value=0.00871). Conclusion The paramedian and midline approach to coccygectomy are both viable treatments for coccygodynia. The two methods offer low complication rates and high patient satisfaction. Surgeon and patient preference should be taken into account when choosing a surgical approach for coccygectomy. Further examination comparing traditional midline vs. paramedian approach are needed to assess superiority.http://www.jmisst.org/upload/pdf/jmisst-2020-00143.pdfchronic coccydyniacoccygectomyparamedian approachsurgical approach |
| spellingShingle | Kyle Geiger Carson Fuller Crystal Gomez Miguel A. Schmitz Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical Note Journal of Minimally Invasive Spine Surgery and Technique chronic coccydynia coccygectomy paramedian approach surgical approach |
| title | Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical Note |
| title_full | Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical Note |
| title_fullStr | Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical Note |
| title_full_unstemmed | Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical Note |
| title_short | Paramedian Approach to Coccygectomy in the Treatment of Chronic Coccydynia: A Technical Note |
| title_sort | paramedian approach to coccygectomy in the treatment of chronic coccydynia a technical note |
| topic | chronic coccydynia coccygectomy paramedian approach surgical approach |
| url | http://www.jmisst.org/upload/pdf/jmisst-2020-00143.pdf |
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