Advertisement

Anatomical Science International

, Volume 88, Issue 4, pp 204–211 | Cite as

Evaluation of coccygeal bone variability, intercoccygeal and lumbo-sacral angles in asymptomatic patients in multislice computed tomography

  • Piotr PrzybylskiEmail author
  • Marcin Pankowicz
  • Agata Boćkowska
  • Elżbieta Czekajska-Chehab
  • Grzegorz Staśkiewicz
  • Maria Korzec
  • Andrzej Drop
Original Article

Abstract

The coccyx is a highly variable structure in the human caudal spine. Previous studies have revealed a significant correlation between coccyx shape and the pain syndrome coccygodynia. The aim of this study was to carry out a complex morphological evaluation of the coccyx in a group of asymptomatic patients of different sex and age examined by multislice computed tomography (MSCT) of the pelvis for different clinical reasons. MSCT pelvis examinations from various nontraumatic clinical conditions from consecutive adult patients (250 males and 250 females of comparable age, mean 54.9 ± 14.8 years) were used. Based on middle sagittal plane reconstructions: coccyx configuration (types I–IV according to Postacchini and Massobrio classification, each successive type characterized by a more pronounced anterior position of coccyx), number of segments, length and angles (intercoccygeal and lumbo-sacral) were measured. The results obtained were analyzed statistically. The following types of coccyx were observed in the study group: type I in 16.2 %, type II 40.0 %, type III 32.4 %, and type IV 11.4 % cases. In most cases (50.8 %), three segments were noted. Lumbo-sacral angle varied from 15.6° to 66.4° (average 41.6° ± 7.7°), and intercoccygeal angle from 0° to 107° (average 51° ± 23.3°). A significant negative correlation between age and number of segments as well as age and intercoccygeal angle was observed. In males, the coccyx was significantly longer, while in females the intercoccygeal angle was significantly wider. Type I was significantly more frequent in males, while type IV was found more often in females. The results obtained differ from other results in the literature. Our research could be useful to determine population standards, and help (together with clinical history) future studies of associations between idiopathic coccygodynia and coccyx morphology.

Keywords

Coccyx Variability Coccygodynia Multislice computed tomography 

Notes

Conflict of interest

No grants were used for the purpose of this article and the authors have nothing to declare. The authors have no conflicts of interest and no financial disclosures.

References

  1. Cheng S et al (2011) Coccygectomy for stubborn coccydynia. Chin J Traumatol 14(1):25–28PubMedGoogle Scholar
  2. Chuerie AG et al (2002) Cocciogodinia: tratamento cirurgico. Acta Ortop Bras 10(4):26–30CrossRefGoogle Scholar
  3. Datir A, Connell D (2010) CT-guided injection for ganglion impar blockade: a radiological approach to the management of coccydynia. Clin Radiol 65(1):21–25PubMedCrossRefGoogle Scholar
  4. Feldbrin Z et al (2005) Coccygectomy for intractable coccygodynia. IMAJ 7:160–162PubMedGoogle Scholar
  5. Ferguson AB (1934) Clinical and roentgen interpretation of lumbosacral spine. Radiology 22:548–558Google Scholar
  6. Fogel RG et al (2004) Coccygodynia: evaluation and management. J Am Acad Orthop Surg 12:49–54PubMedGoogle Scholar
  7. Kerimoglu U et al (2007) Intercoccygeal angle and type of coccyx in asymptomatic patients. Surg Radiol Anat 29:683–687PubMedCrossRefGoogle Scholar
  8. Kim NH, Suk KS (1999) Clinical and radiological differences between traumatic and idiopathic coccygodynia. Yonsei Med J 40:215–220PubMedGoogle Scholar
  9. Magine JY, Doursounian L et al (2000) Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine 25(23):3072–3079CrossRefGoogle Scholar
  10. Maigne JY, Lagauche D et al. (2000) Instability of the coccyx in coccydynia. J Bone Joint Surg 82-B:1038–1041Google Scholar
  11. Maigne JY, Tamalet B (1996) Standardized radiologic protocol for the study of common coccygodynia and characteristics of the lesions observed in the sitting position. Clinical elements differentiating luxation, hypermobility, and normal mobility. Spine 21:2588–2593PubMedCrossRefGoogle Scholar
  12. Patel R et al (2008) Coccydynia. Cerr Rev Musculoskelet Med 3–4:223–226CrossRefGoogle Scholar
  13. Postacchini F, Massobrio M (1983) Idiopathic coccygodynia: analysis of fifty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg Am 65:1116–1124PubMedGoogle Scholar
  14. Richards HJ (1954) Causes of coccydynia. J Bone Joint Surg Br 36:142–144Google Scholar
  15. Stern FH (1967) Coccygodynia among the geriatric population. J Am Geriat Soc 15:100–102PubMedGoogle Scholar
  16. Wray C et al (1991) Coccydynia aetiology and treatment. J Bone Joint Surg 73-B:335–338Google Scholar
  17. Zayer M (1996) Coccygodynia. Ulster Med J 65:58–60PubMedGoogle Scholar

Copyright information

© Japanese Association of Anatomists 2013

Authors and Affiliations

  • Piotr Przybylski
    • 1
    Email author
  • Marcin Pankowicz
    • 1
  • Agata Boćkowska
    • 1
  • Elżbieta Czekajska-Chehab
    • 1
  • Grzegorz Staśkiewicz
    • 1
    • 2
  • Maria Korzec
    • 1
  • Andrzej Drop
    • 1
  1. 1.First Department of Radiology with Telemedicine UnitMedical University of LublinLublinPoland
  2. 2.Department of Human AnatomyMedical University of LublinLublinPoland

Personalised recommendations