TREATMENTS
COCCYGECTOMY
Coccygectomy is surgery to remove an injured tailbone, also known as the coccyx.
Coccygectomy
Coccydynia is what we refer to as tailbone pain. Tailbone pain radiates from the bony structure at the base of the spine (coccyx). The coccyx, a vestigial tail, is an arrangement of bone in the form of a triangle. The tailbone comprises 3-5 different bones that connect by means of ligaments and joints. Even though researchers consider the coccyx a remnant of our past, which we no longer need, the tailbone does play a crucial role in our stability and balance. This bony formation supports the entire pelvic structure and distributes weight evenly, especially when sitting. The tailbone also serves as a connective point for pelvic floor muscles. As a vital support structure, the coccyx aids the function of the pelvic floor muscles, controlling movement and supporting female organs.
What can go wrong with the coccyx?
Women are generally more susceptible to coccyx injuries because of their broad pelvic structure. An extensive pelvis limits rotational movements, and in turn, places the coccyx at a higher risk of injury. Childbirth is another risk factor. While delivering a child, the newborn passes over the tailbone when exiting the birth canal, causing acute damage to the coccyx.
Coccydynia can intensify when moving from a sitting to a standing position due to rotating pelvic bones or twisting of the muscles. Tailbone pain also increases during sexual intercourse or bowel movement due to its proximity to the genital region and rectum.
Procedure
Nerve blocks, steroid injections, physiotherapy and anti-inflammatories are non-surgical treatments for tailbone pain. When coccydynia persists and cannot resolve even by means of conservative treatment, surgery remains the only option to correct the issue. Surgeons specialising in spinal surgery perform a coccygectomy to either remove the entire coccyx or just a portion of it.
During surgery, Dr Makan makes a three-to-four-centimetre incision over the coccyx and dissects its protective cartilage. He removes the coccyx and, if necessary, tissue for biopsy in case of a spinal tumour. After the tailbone is removed, the incision will be stitched closed and the wound dressed.
Recovery
Coccygectomy to treat tailbone pain is relatively straightforward, but recovery is a long process. Prescription pain medication helps relieve discomfort during this time, and physical therapy exercises strengthen the back. It takes months, sometimes a year, to recover from tailbone surgery completely.
FAQ
Although the triangular tailbone provides support while you sit, you can live a normal, healthy life without it.
Risk factors for tailbone pain are ageing, strain injuries, a coccyx injury, bad posture, being overweight, or a spine infection and spine tumour. Childbirth is another cause of tailbone pain. Even though the coccyx is more flexible closer to delivery of the baby, ligaments and muscles can overstretch and lead to tailbone pain.
Physical therapy, corticosteroids, anti-inflammatories and nerve blocks are conservative treatments to relieve tailbone pain. When all else fails, your doctor will recommend an orthopaedic surgeon for a full or partial coccygectomy to treat pain.