Traumatic coccydynia patients benefit from coccygectomy more than patients undergoing coccygectomy for non-traumatic causes

Purpose Conservative treatment is the first step in the management of coccydynia. However, surgical treatment is required in cases where conservative treatment fails. The aim of this study was to compare the effect of traumatic and atraumatic etiologies on functional outcomes in patients who underwent coccygectomy for chronic coccydynia. Methods Ninety-seven patients who underwent partial coccygectomy between October 2010 and December 2018 for the diagnosis of chronic coccygodynia were evaluated retrospectively. The patients were divided into two groups according to etiologies as atraumatic (group AT) and traumatic (group T). Concomitant disorders of the patients were recorded as psychiatric and musculoskeletal diseases. Visual Analog Scale (VAS) for low back pain, the Oswestry Disability Index (ODI) scale, Short Form-36 Physical Component Summary and Short Form-36 Mental Component Summary were used to evaluate the clinical outcomes pre- and postoperative at the last follow-up. Results The mean follow-up time was 67.3 [+ or -] 13.9 (range; 44-115) months. Group AT and group T included 48 (mean age 37.1 [+ or -] 11.3 and 36 (75%) female) and 49 patients (mean age 36 [+ or -] 11 and 35 (71.4%) female), respectively. The groups were statistically similar in terms of age (p = 0.614), gender (p = 0.691), body mass index (p = 0.885), tobacco usage (p = 0.603) and duration of pain (p = 0.073). However, the rate of musculoskeletal and total concomitant disorders was higher in the Group AT than in Group T (p < 0.05). The average preoperative SF-36 MCS and SF-36 PCS scores improved at the last follow-up from 43.3 [+ or -] 6.2 and 35.6 [+ or -] 4.9 to 72 [+ or -] 14.1 and 58.3 [+ or -] 10.9, respectively. The preoperative VAS and ODI decreased from 8 [+ or -] 1.4 and 39.8 [+ or -] 8.5 to 2.6 [+ or -] 1.8 and 13.4 [+ or -] 8.9 at the last follow-up, respectively. Conclusion Successful results were obtained with surgical treatment in chronic coccygodynia. In addition, functional outcomes in patients with traumatic etiology are better than in atraumatic ones. Levels of evidence Level III; Retrospective Comparative Study. Keywords: Coccyx, Coccydynia, Coccygectomy, Etiology, Tail bone