Review article
https://doi.org/10.20471/acc.2023.62.s4.14
Coccygodynia
Neven Elezović
orcid.org/0009-0006-1837-1135
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Split University Hospital Center, Split, Croatia
Sanda Stojanović Stipić
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Split University Hospital Center, Split, Croatia
Mate Perković
; Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Split University Hospital Center, Split, Croatia
Anela Elezović
; Health School, Split, Croatia
Toni Elezović
; University of Split, School of Medicine, Split, Croatia
Abstract
The coccyx, the last segment of the spine, joins the sacrum at the base. It has three
to five vertebrae, which are typically fused. In front of the sacrococcygeal junction is the ganglion
impar, the only unpaired autonomic ganglion. The two sympathetic chains come to a close there.
The impar ganglion is traversed by sympathetic nerves carrying pain fibers from the perineum, distal
sections of the rectum, the vagina and the urethra. The painful disorder known as coccygodynia,
which affects the tail end of the spine, is frequently brought on by birth trauma or is caused by an
unidentified factor. Even though the pain may go away on its own or with therapy, it may also linger
and worsen over time. Due to increased stress from the female pelvis on the coccyx, it affects women
five times more frequently than it does men. Conservative, invasive or surgical treatment options
are available for coccygodynia (partial or total coccygectomy). Rest, nonsteroidal anti-inflammatory
medicines (NSAIDs) or COX-2 inhibitors, acupuncture, coccyx cushions, physical therapy, manual
therapy and invasive therapy, which involves ganglion impar block with injections of local anesthetic
and corticosteroid under fluoroscopy, followed by radiofrequency ablation, spinal cord stimulation
(SCS) or peripheral nerve stimulation, are examples of conservative treatments. Coccygectomy is recommended
in refractory situations.
Keywords
nic pain; coccyx; tailbone pain; ganglion impar block
Hrčak ID:
316571
URI
Publication date:
1.11.2023.
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