Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P178. Coccydynia, outcome one-year after surgical treatment of 138 consecutive patients

BACKGROUND CONTEXT Coccydynia caused by trauma or giving birth is mostly reported in females in the age 30-60years. Many treatment modalities have been suggested including special pillows, steroid injections, special physiotherapy and pain medication. Patients suffering from coccydynia reports severe pain and reduced Health related quality of life. Surgical treatment, can relieve persistent pain in patients suffering from coccydynia.This study reports the outcome, after surgical removal of coccyx in 138 consecutive patients. PURPOSE The purpose of this study is to report the outcome and rate of complications, 1 year after surgical treatment with partial or complete removal of the coccyx. STUDY DESIGN/SETTING A prospective cohort study. PATIENT SAMPLE Patients suffering from persistent coccydynia, for at least 12 months, after a blunt trauma. OUTCOME MEASURES Patient Reported Outcome Measures, SF- 36PCS/MCS, ODI, EQ5D, VAS Back/VAS Leg. METHODS Patients are evaluated by examination with bimanual palpation of the coccyx, and examination of the pelvic ligaments. If abnormal movement is present and the pain mechanism can be activated during examination of the coccyx, surgery with full or partially removal of the coccyx bone is suggested. All patients are treated with steroid injections prior to surgery, with only short term relief. RESULTS A total of 138 consecutive patients was treated at the Sector for Spine Surgery, Middelfart Hospital and evaluated 3 and 12 months after surgery. Three months after surgery, 40% of the patients are pain free in sitting position, 47% of the patients are experiencing some degree of discomfort in sitting position but are improved and 13% of the patients are still experiencing pain while sitting. A total of 99 patients are satisfied, 1 year after the surgery. A total of 22 patients have hoped to have a bigger improvement and 17 patients are not satisfied. A total of 32 patients developed infections after surgery and received antibiotics, 5 reoperations was performed, 3 due to infections and 2 due to rupture of the skin after return to normal daily living 3 months after surgery. CONCLUSIONS Pain in the coccyx after trauma or birth, are a quite common condition in women. Patients with severe symptoms and a history of pain duration of more than 12-18 months, should be referred for spine surgical evaluation. Partial or complete resection of the coccyx, is a safe procedure with in most patients will relieve the pain and restore the ability to sit.