Images in clinical medicine | Volume 36, Article 135, 26 Jun 2020 | 10.11604/pamj.2020.36.135.19904

About an observation of coccydynia treated by surgery

Noukhoum Koné

Corresponding author: Noukhoum Koné, Service de Neurochirurgie, Centre Hospitalier de Kiffa, Kiffa, Mauritanie

Received: 28 Jul 2019 - Accepted: 19 Mar 2020 - Published: 26 Jun 2020

Domain: Neurosurgery,Orthopedic surgery

Keywords: Coccydynia, coccygiectomy, coccyx

©Noukhoum Koné et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Noukhoum Koné et al. About an observation of coccydynia treated by surgery. Pan African Medical Journal. 2020;36:135. [doi: 10.11604/pamj.2020.36.135.19904]

Available online at: https://www.panafrican-med-journal.com/content/article/36/135/full

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Images in clinical medicine

About an observation of coccydynia treated by surgery

About an observation of coccydynia treated by surgery

Noukhoum Koné1,&

 

1Service de Neurochirurgie, Centre Hospitalier de Kiffa, Kiffa, Mauritanie

 

 

&Corresponding author
Noukhoum Koné, Service de Neurochirurgie, Centre Hospitalier de Kiffa, Kiffa, Mauritanie

 

 

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Coccygodynia is pain located in coccyx. Factors that increase are stay position and stand up. Trauma seems to be his first cause, it can be falled in a sitting position, post-delivery or repeated micro-trauma. Therapeutic management depends on the mechanism involved and relies on manual treatments, infiltrations, even surgery, with good results and a success rate of about 90%. We report the case of a 23-year-old patient with disabling coccygeal pain, progressively worsening, following a fall of a floor 4 meters high, the patient sitting with reception on the buttocks. The pains have a repercussion on the sphincter function with the installation of a rather severe constipation. The examination finds an exquisite pain with regard to the sacrum on palpation without any sign of disco-radicular conflict and the skin facing is normal. The patient has tried everything in terms of conservative treatment including manipulations. The sacro-coccygeal CT shows in sagittal section (A) a dislocation of the entire coccyx compared to the 5th sacred piece. The incision arcuate (B) was preferred over the median vertical incision in the intergluteal fold closer to the anus with a non-nefiable infectious risk, ranging from 6.15 to 16.6% depending on the data from the terature. Excision of the coccyx (C) was performed under general anesthesia, the patient installed in ventral decubitus. The clinical evolution was significantly favorable.

 

 

Figure 1: (A) sacro-coccygeal CT scan showing in sagittal section, a dislocation of the entire coccyx compared to the 5th sacred piece; (B) surgical approach; (C) an excision of the coccyx

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

About an observation of coccydynia treated by surgery

Images in clinical medicine

About an observation of coccydynia treated by surgery

Images in clinical medicine

About an observation of coccydynia treated by surgery