Article Figures & Data
Figures
- Figure 1
A 1-inch incision lateral to midline.
- Figure 2
Excised coccyx.
- Figure 3
Skin closure.
- Figure 4
Incision dressing.
Tables
Demographics N = 173 Age at the time of surgery, y Mean 46.6 ± 14.1 Range 17–83 Gender, female, n (%) 134 (77%) Mechanism of injury, n (%) Chronic/spontaneous pain (unknown) 73 (42.2%) Fall/motor vehicle crash/other accident 71 (41%) Previous back surgery 3 (1.7%) Vaginal delivery 12 (6.9%) Sports 4 (2.3%) Rapid weight loss 3 (1.7%) Other (eg, osteophyte on coccyx, achondroplasia, spina bifida occulta) 7 (4%) History of prior spine surgery, n (%) Yes 23 (13.3%) No 139 (80.3%) Unknown 11 (6.4%) Mean duration of symptoms, y 6 Mean time to follow up following surgery, y 5.6 Conservative therapy, n (%) (n = 166) Medications 85 (51.2%) Heat/Cold 85 (51.2%) Physical therapy 70 (42.2%) Rest 74 (44.6%) Exercise 60 (36.1%) Manipulation 61 (36.7%) TENS (transcutaneous electrical nerve stimulation) 35 (21.1%) Acupuncture 18 (10.8%) Injections (eg, steroid) 110 (66.3%) Ganglion impar injection 23 (13.9%) Radiofrequency ablation 8 (4.8%) Coccyx morphology,a n (%) (n = 110) Type I 35 (20.2%) Type II 26 (15%) Type III 28 (16.2%) Type IV 21 (12.1%) aBased on the Postacchini and Massobio classification system.18
Level Mobility Self-Care Usual Activities Pain/Discomfort Anxiety/Depression 1 (No problems) 35 40 29 15 34 2 (Slight problems) 7 4 8 14 4 3 (Moderate problems) 3 2 6 13 9 4 (Severe problems) 1 1 3 2 0 5 (Extreme problems) 2 1 2 0 1 Mean (SD) health self-score (possible range, 0–100) = 71.44 ± 19.26.
- Table 3
One-way analysis of variance of age and duration of symptoms among 4 groups of coccyx morphologies.
Source of Variation Sum of Squares df Mean Square F P value Age Between groups 1816.248 3 605.416 3.285 0.024 Within groups 19533.242 106 184.276 Total 21349.491 109 Duration of symptoms Between groups 44.599 3 14.866 0.295 0.829 Within groups 5339.469 106 50.372 Total 5384.068 109 Quality of Life Measure Preoperative Postoperative N Mean (SD) N Mean (SD) P value (paired t test) Oswestry Disability Index (0–100) 12 62.67 (29.16) 49 22.90 (22.47) 0.001 Visual analog scale (0–10) 58 6.97 (1.99) 51 3.49 (3.24) 0.000 Physical functiona 15 41.40 (8.79) 50 46.61 (11.04) 0.069 Depressiona 15 52.35 (10.43) 50 47.94 (9.69) 0.134 Anxietya 15 44.51 (11.53) 50 49.74 (11.76) 0.105 Fatiguea 15 59.49 (9.06) 50 50.27 (10.50) 0.008 Sleep disturbancea 15 55.55 (9.33) 50 48.29 (10.97) 0.024 Satisfaction with social rolea 15 43.85 (14.28) 50 52.47 (10.98) 0.016 Pain interferencea 15 64.91 (6.39) 50 54.75 (11.63) 0.000 Pain intensityb 15 5.80 (2.11) 50 3.86 (2.96) 0.021 aPatient-Reported Outcomes Measurement Information System-29 domain T score (mean = 50, SD = 10).
bPatient-Reported Outcomes Measurement Information System-29 score (0–10).
Quality of life measure Z P Value PROMIS-29 Pain intensity −2.414 0.016 Pain interference −2.414 0.016 Social role −1.051 0.293 Fatigue −1.859 0.063 Sleep disturbance −1.859 0.063 Depression −1.604 0.109 Anxiety −0.944 0.345 Physical function −0.841 0.400 ODI −1.363 0.173 VAS −1.980 0.048 ODI, Oswestry Disability Index; PROMIS-29, Patient-Reported Outcomes Measurement Information System-29; VAS, visual analog scale.
Variable P value (2-Sided) PROMIS-29 pain interference (n = 7) Sex NAa Trauma 0.486 Ganglion impar injection 0.429 Steroid injection 0.429 Physical therapy 1.000 Back surgery 1.000 Delivery 1.000 Age >65 y 0.429 PROMIS-29 physical function (n = 7) Sex NAa Trauma 0.486 Ganglion impar injection 0.429 Steroid injection 0.429 Physical therapy 1.000 Back surgery 1.000 Delivery 1.000 Age >65 y 0.429 ODI (n = 6) Sex NAa Trauma 0.400 Ganglion impar injection 1.000 Steroid injection 1.000 Physical therapy 0.400 Back surgery NAb Delivery 0.467 Age >65 y 1.000 aNo statistics computed because sex was constant.
bNo statistics computed because back surgery was constant.
NA, not applicable; ODI, Oswestry Disability Index; PROMIS-29, Patient-Reported Outcomes Measurement Information System-29; VAS, visual analog scale.
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