Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

Computed Tomography–Based Morphologic and Morphometric Features of the Coccyx Among Arab Adults

Marwan, Yousef Abbas, BMedSc, BMBCh*; Al-Saeed, Osama Mhawes, MBBCh, ABR†,‡; Esmaeel, Ali Abdulla, BMedSc, BMBCh, FRCSC*,§; Kombar, Osama Rabie Ahmad, MBBCh, MSc, MD†,¶; Bendary, Abdulla Mohammad, MBBCh, MSc; Azeem, Mokhtar Elsayed Abdul, MBBCh, MSc, MD*

doi: 10.1097/BRS.0000000000000515
Anatomy

Study Design. Cross-sectional, retrospective.

Objective. To identify morphological and morphometric features of the coccyx among adult Arabs.

Summary of Background Data. Different sacrococcygeal morphologic features were found to be associated with coccydynia.

Methods. Review of 202 computed tomographic scans of adult Arab subjects was done (mean age: 47.98 ± 16.46 yr). Sacrococcygeal morphological features including number of coccygeal segments, type of coccyx, joint fusion, joint subluxation, coccygeal spicule, coccygeal sacralization, ventral angulation of the terminal sacral segment (S5), and lateral deviation of coccygeal tip were recorded. Moreover, morphometric measurements including lengths and angles of the sacrococcygeal region were measured. Analysis of data was carried out using P value of less than 0.05 as the cutoff level of significance.

Results. Three coccygeal segments were present in 138 (68.3%) of individuals. The majority of the subjects had coccyx type I (96; 47.5%), II (70; 34.7%), or III (31; 15.3%); type I being more common among males (P = 0.004). Bony spicule was present in 109 (54.0%) individuals. Joint fusion, joint subluxation, coccygeal sacralization, ventral angulation of S5, and lateral deviation of coccygeal tip were present in 38.6%, 31.7%, 34.2%, 38.1%, and 38.6% of the subjects, respectively. Joint subluxation and ventral angulation of S5 were more significantly present among females (P = 0.015, P = 0.014, respectively). The mean straight and curved lengths of the coccyx were 3.3 ± 0.7 cm and 3.7 ± 0.8 cm, respectively. The sacrococcygeal structures were longer in males than in females. The mean sacrococcygeal joint angle was 149.2°± 28.1°. Based on the morphometric measurements, the coccyx was more ventrally angulated among females.

Conclusion. The coccygeal morphology and morphometry of Arab adults share some similarities and differences with individuals of other ethnic backgrounds. Future studies should investigate the relation between these anatomic features with coccydynia among this population.

Level of Evidence: 3

This study examined the computed tomographic, morphologic, and morphometric features of the coccyx among Arab adults. This ethnic group found to share few similarities and differences of coccygeal radiological anatomy with others. Based on the current findings, this population seems to be at a possible risk of coccydynia.

*Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, Kuwait City, Kuwait

Department of Radiology, Al-Amiri Hospital, Kuwait City, Kuwait

Department of Radiology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait

§Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait; and

Department of Radiology, Mansoura University, Mansoura, Egypt.

Address correspondence and reprint requests to Yousef Abbas Marwan, BMedSc, BMBCh, Department of Orthopaedic Surgery, Al-Razi Orthopaedic Hospital, PO Box 24923, Safat 13110, Kuwait City, Kuwait; E-mail: yousefmarwan@hotmail.com

Acknowledgment date: March 17, 2014. Revision date: May 3, 2014. Acceptance date: June 29, 2014.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

No relevant financial activities outside the submitted work.

© 2014 by Lippincott Williams & Wilkins