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Coccygodynia: Evaluation and Management

Lithwick, Norton H. BSc, MD

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Journal of the American Academy of Orthopaedic Surgeons: July 2004 - Volume 12 - Issue 4 - p 289
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To the Editor: I was impressed with the thorough article about coccydynia.1 The term coccydynia is far more descriptive and mellifluous than coccygodynia. One wonders why the “go” was added.

Also, many patients use donuts, which do not take pressure off the painful coccyx. A coccygectomy pillow with a large V cutout in the back is far more effective.

Finally and most importantly is the surgical procedure. In over thirty such operations, the key to successful surgery is removal of the sacral cornu. This involves removal of the terminal prominent 1 cm of the sacrum, rongeuring it to smoothness with the remaining sacrum. Leaving this terminal piece has resulted in reoperation in a few patients with success. In my opinion, persisting pain with failure of nonsurgical measures is an indication for surgery, with little consideration given to coccygeal mobility.

Norton H. Lithwick BSc, MD

Toronto, Ontario


© 2004 by American Academy of Orthopaedic Surgeons