Misdiagnosis between coccygeal dislocation fracture and lumbosacral disc herniation

Authors

Gilberto Gardea-Loera, Hospital Vistas del Sol, Delicias Chihuahua
Gilberto Gardea-Ramírez, Universidad Autónoma de ChihuahuaFollow
Ylián Ramírez-Tapia, Dr. Eduardo Liceraga Hospital General de México

Corresponding Author

Gilberto Gardea-Loera ADDRESS: Calle 9a Sur No- 2007, Col Las Granjas, Cd. Delicias Chihuahua, CP:33077. Email: gilbertogardealoera@gmail.com ORCID:000-0002-3678-7234

Document Type

Original Research - Spine

Abstract

INTRODUCTION: Coccydynia is the condition of disabling pain in the coccyx that occurs when sitting or moving to a standing position. Due to a lack of knowledge by spine specialists, many patients suffer for years without adequate treatment. We highlight the relevance of diagnosing and treating coccygodynia correctly to avoid lumbosacral pathology overestimation. METHODS: We present a series of patients with painful coccygeal segment syndrome associated with different lumbar alterations who underwent coccygectomy from 1996 to 2021 in our spine clinic. We describe VAS and MacNab scores and complication rates. We used Student-T-Test for statistical analysis. RESULTS: We included 40 patients, 36 women and four men, mean age of 41.75 years old. Twenty-one patients were idiopathic, six were because of labor, and 13 cases were due to trauma. We also included the data of 6 patients who simultaneously underwent coccygectomy and spine surgery. The results on the VAS scale 15 days after coccygeal surgery showed a significant improvement from a preoperative 9.63 (SD 0.54) to 1.6 (SD 0.71), with further improvement at four months to 0.50 (SD 0.71). Thirty-five patients were excellent, three good, one fair, and one poor regarding the Macnab scale. There was an infection in 3 patients (7.5%), totally improving with antibiotics and daily wound cleaning; 9 (22.5%) had superficial and partial wound dehiscence. CONCLUSIONS: We suggest making a differential diagnosis of coccydynia in all patients with lumbosacral pathology. Patients improve significantly after coccygectomy, although infection and wound dehiscence are the main complications.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Gardea-Loera, Gilberto; Gardea-Ramírez, Gilberto; and Ramírez-Tapia, Ylián (2024) "Misdiagnosis between coccygeal dislocation fracture and lumbosacral disc herniation," Archives of Neurosurgery: Vol. 2: Iss. 1, Article 9.
Available at: https://www.ansjournal.org/home/vol2/iss1/9