Coccygectomy for coccygeal spicule: a study of 33 cases

Purpose To report the results of coccygectomy for coccygeal spicule. Methods We report the results of a retrospective series of 33 patients who underwent coccygectomy for coccygeal spicule. There were 31 women and 2 men. The mean age was 42 ± 12 years (range 23–62). There was a pit in the skin overlying the spicule in 14 cases and the spicule was bulky in 8 cases. In three cases, weight loss had preceded the occurrence of the coccygodynia. The coccyx was rigid or had very reduced mobility (less than 5) in 25 cases and normal mobility (between 5 and 20 of flexion) in 8 cases. All the patients had initially been managed conservatively with injections targeted on the spicule. As they did not obtain sufficient relief, they were offered surgery. Ten patients were followed up for more than 72 months, 10 patients for 48–66 months, and 13 for 30–42 months. The outcome analysis involved functional criteria only. Results Twenty-six patients (79 %) had a very satisfactory outcome and 7 (21 %) an unsatisfactory outcome. When asked ‘Would you have the surgery again?’, only one patient answered in the negative. Conclusions Surgical treatment for coccygeal spicules that are causing coccygodynia and are resistant to conservative treatment gives satisfactory outcomes, similar to those obtained from surgery for instability of the coccyx.