What is Coccygectomy: Overview, Benefits, and Expected Results

Definition and Overview

Coccygectomy is the partial or complete surgical removal of the coccyx or the tailbone, which is located near the rectum and connected to the sacrum, or the triangular bone that makes up the base of the spine.

This procedure is considered rare and is often the last resort for patients who do not respond to non-surgical therapies. The chances of experiencing post-operative pain and enduring a very long recovery period that can last for months to a year are the common reasons why many surgeons are apprehensive to even recommend the procedure. Nevertheless, as long as the surgeon is experienced and the patient is otherwise healthy, coccygectomy is known to produce very positive outcomes.

Who Should Undergo and Expected Results

Tailbone removal is done as the last-ditch effort to relieve pain in the lower back, especially the coccyx. This pain can be caused by:

• The growth of a rare type of tumor called sacrococcygeal teratoma (SCT), which is more commonly diagnosed among newborns
• Traumatic injuries such as a serious fall or a vehicular accident
• An infection that has occurred or spread to the sacrum and the coccyx
• Stress on the lower back caused by lifting heavy objects, among others
  Patients with lower back pain that involves the coccyx are often advised to try non-surgical therapies like massages, medications such as antibiotics, spinal manipulation, rest, compress therapy, and change of lifestyle before a coccygectomy is even considered. These may be done for a few months, after which the outcomes are evaluated. If the pain does not improve, surgical interventions are explored.

As long as the patient is in good condition and the surgeon is highly experienced in this type of procedure, the success rate can be as high as 80%. However, removing a part or the entire coccyx does not mean that spinal or back pain will no longer recur in the future.

How Does the Procedure Work?

Coccygectomy or tailbone removal is a quick procedure that can be completed in less than an hour and on an outpatient basis, although it is best performed in a hospital. The patient, while lying prone and with the lower back near the anus is exposed, is administered with general anaesthesia.

Using a scalpel, the surgeon makes an incision directly in the skin where the tailbone is located, going through the subcutaneous tissue and the periosteum, or the connective tissue that surrounds the bone. With precision, the surgeon begins to cut away the tailbone from back to front, making sure that no other tissues are involved. Once the procedure is done, the incision is sutured.

The removed tailbone may be sent to a lab for a biopsy to check for the presence of cancerous cells.

Complications and Risks

Pain remains to be one of the most common complications of the tailbone removal procedure, and it may begin right after surgery and last for a few months to a year. In some cases, the pain doesn’t disappear at all, and other follow-up surgeries or treatments are considered. Also, while the surgical wound is still healing and the pain persists, the patient may have trouble walking, sleeping, and sitting.

Aside from pain, an infection can also occur not only because of the surgical site but also because of the possibility that some tissue that is part of the rectum is cut or touched, giving pathogens and contaminants more space to get in. Other studies have also shown that adult patients may develop hernia, wherein parts of the pelvis bulge downward and out of the pelvic floor.

References:

• Balain B, Eisenstein SM, Alo GO, Darby AJ, Cassar-Pullicino VN, Roberts SE, et al. Coccygectomy for coccydynia: caseseries and review of literature. Spine. 2006;31:E414–E420.

• Bayne O, Bateman JE, Cameron HU. The influence of etiology on the results of coccygectomy. Clin Orthop Relat Res. 1984;(190):266–272

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**What is Coccygectomy: Overview, Benefits, and⁢ Expected⁤ Results**



**Overview:**



Coccygectomy is a surgical procedure involving the removal of the coccyx, also ‍known as the tailbone. The coccyx‌ is a triangular bone located at the bottom of the ‍spine, just below the sacrum. Coccygectomy is performed to ⁣alleviate chronic pain, discomfort, or other issues related to the coccyx.



**Benefits of⁢ Coccygectomy:**



* **Pain Relief:** The primary benefit of coccygectomy is significant pain relief for ⁤those experiencing chronic pain due to coccydynia, a condition characterized by ⁤persistent pain in⁣ the coccygeal region.

* **Improved​ Sitting ‌Tolerance:** A coccyx that is‌ tilted, dislocated, or fractured can make it painful and uncomfortable to sit. Coccygectomy can restore a normal sitting posture ⁣and reduce discomfort.

* **Mobility Improvement:** In some cases, a coccyx problem can lead to ⁤stiffness and difficulty⁣ with mobility. Coccygectomy can free up ⁢the surrounding⁣ structures and ⁣improve ⁣flexibility.

* **Healing ​of Pressure Sores:** Coccygeal pressure sores can develop due to prolonged sitting ‌on a hard surface. Coccygectomy can remove the pressure source and promote sore healing.



**Expected Results:**



The success rate of ‌coccygectomy for pain relief ranges from‌ 70-90%. Most patients‍ experience ​significant pain improvement and an increase in sitting tolerance.​ However, it’s important to ​note that‍ results vary depending on individual circumstances.



After surgery, patients ​typically remain‌ in⁤ the ‌hospital for​ 1-2 days. Recovery time ⁤usually takes several weeks, during which time ‍patients are advised to avoid prolonged‍ sitting ⁢and strenuous ⁢activities.



**Who is a ⁢Candidate for Coccygectomy:**



Coccygectomy is typically considered for patients who have⁣ persistent coccygeal pain that has not⁤ responded to⁣ conservative treatments such as​ rest, medication, or physical‍ therapy. Candidates must meet certain criteria, including:



* Chronic pain due to coccydynia

* Failed conservative treatments

* Presence of ‌a fractured, dislocated, or tilted coccyx

* No underlying medical conditions that contraindicate surgery



**Conclusion:**



Coccygectomy is a surgical procedure that ‌can effectively alleviate chronic pain and ⁢improve sitting tolerance in patients with coccygeal problems. It is important to discuss the procedure with a qualified doctor to determine if it is the right treatment option for you.