Coccygeoplasty: preliminary experience with this new alternative treatment of refractory coccydynia in patients with coccyx hypermobility
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Le résumé fourni par la source
BACKGROUND: Coccydynia has many causes, including fracture, subluxation, and hypermobility of sacrococcygeal segments. Existing treatments are limited in their effectiveness. Coccygeoplasty (CP) is a relatively new, minimally invasive treatment that appears to address this difficult clinical challenge. OBJECTIVE: To describe clinical results at the time of the procedure and at 3- and 12-months' follow-up of patients with coccydynia related to subluxation and coccyx hypermobility treated with the CP technique. Additionally, to determine if there is any correlation between the final imaging and clinical results at 3- and 12-months' follow-up. METHODS: A prospectively maintained database was used, and all patients who underwent CP for chronic coccydynia between January 2005 and October 2018 were retrospectively reviewed. All the patients had painful hypermobility (greater than 25°) with anterior flexion confirmed on radiological imaging. Alternative causes of coccydynia were excluded using CT and MRI. Procedures were performed under local anesthesia with combined fluoroscopic and CT guidance. Clinical follow-up was performed at two time points: 3 and 12 months after treatment using the Visual Analogue Scale (VAS). RESULTS: Twelve patients were treated in a single center. No procedural complications occurred. At 3- and 12-months' follow-up, the majority (75%) of patients had significantly lower VAS scores than at baseline, with mean changes of 3.5 and 4.9, respectively. There was no pain recurrence at 12 months and just one patient had no improvement of the pain. Follow-up CT images confirmed fixation of the sacrococcygeal bone segments in nine patients; however, no correlation was found between final imaging results and clinical outcome (p=0.1). CONCLUSIONS: Patients with refractory painful coccyx subluxation and hypermobility undergoing CP have a favorable clinical response at 3- and 12-months' follow-up. Further studies are required to validate this technique and to identify predictors of treatment response. Coccygeoplasty may be considered a reasonable alternative to coccygectomy.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Coccygeoplasty: preliminary experience with this new alternative treatment of refractory coccydynia in patients with coccyx hypermobility
- Date Crossref
- 26/07/2022
- Éditeur
- BMJ
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Mediterranean University pays non établi dans la noticeUniversité ou école supérieure
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Algarve Biomedical Center pays non établi dans la noticeStructure de recherche
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Unidade Local de Saúde de São José pays non établi dans la noticeÉtablissement de santé
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Oxford University Hospitals NHS Trust Department of Neuroradiology pays non établi dans la noticeÉtablissement de santé
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Centro Hospitalar de Lisboa Ocidental Department of Neuroradiology pays non établi dans la noticeÉtablissement de santé
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Azienda Ospedaliero Universitaria San Giovanni Battista pays non établi dans la noticeÉtablissement de santé
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Monash Health pays non établi dans la noticeÉtablissement de santé
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Monash University Department of Image pays non établi dans la noticeUniversité ou école supérieure
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IRCCS Humanitas Research Hospital pays non établi dans la noticeÉtablissement de santé
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Massachusetts General Hospital NeuroEndovascular Program pays non établi dans la noticeÉtablissement de santé
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IOM Mediterranean Oncology Institute Department of Radiology pays non établi dans la noticeStructure de recherche
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Department of Radiology pays non établi dans la noticeInstitution
Mediterranean University, Algarve Biomedical Center et Unidade Local de Saúde de São José, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.