Giant-cell tumor is considered one of the benign tumors which is predilected at an ends of a long bone. Although many reports of giant-cell tumor affecting the sacrum have been recentIy presented, the report of the tumor involving coccyx is not comparatively frequent. A case of relatively uncommon giant-cell tumor involving the coccyx is presented with the review of the relevant literature.
Coccyx ; Sacrum

PURPOSE: Coccygodynia is a painful condition localized in the region of the coccyx. Most cases of coccygodynia are treated conservatively. However, we conducted an analysis of patients who underwent coccygectomy, with chronic intractable coccygodynia and assessed the results of their treatment. MATERIALS AND METHODS: From March 2003 to August 2013, this study was conducted in order to investigate the benefit of coccygectomy in cases where conservative treatment has failed. We compared preoperative and postoperative visual analog scales (VAS) scores and confirmed duration of symptom free, complications. RESULTS: The average duration of symptom free was 3.4 months, and VAS score improved from 7.3 to 1.6. There was one wound infection. CONCLUSION: We can obtain satisfactory results through coccygectomy for chronic intractable coccygodynia.
Coccyx ; Humans ; Visual Analog Scale ; Wound Infection

An eccrine nevus is a rare hamartoma characterized by an increase in the number or size of eccrine glands. Eccrine nevi usually present as localized hyperhidrosis and are not associated with overlying skin abnormalities. However, among the cases that have been reported in the literature, some unique presentations of eccrine nevi have been demonstrated, including a pigmented patch, a depressed nodule, linear papules, and a sacral skin tag. Herein, we report two unusual cases of coccygeal polypoid eccrine nevi and review the literature.
Coccyx ; Eccrine Glands ; Hamartoma ; Hyperhidrosis ; Nevus ; Skin ; Skin Abnormalities

BACKGROUND: Many factors determine the distribution of local anesthestics in the subaracnoid space. Especially, patient's height is considered an important determinant of the dose of spinal anesthesia. However, the relationship between height and the level of analgesia has not been clearly documented. We studied the correlation between vertebral lengths measured from C7 to the level of the iliac crest (C7-IC), to the sacral hiatus (C7-SH) and to the coccyx (C7-CX) and the level of analgesia injected a fixed amount of local anesthetic in spinal anesthesia. METHODS: Fifty six healthy patients who consented to spinal anesthesia for elective operation were studied. All patient were administered 0.5% hyperbaric bupivacaine 11 mg in the lateral decubitus position on a horizontal operation table. Immediately after drug injection, the patients were turned to the supine horizontal position. For the first 30 minutes, we measured the level of analgesia to pinprick every two minutes. RESULTS: The average of maximum cephalad spread of analgesia was T7.0 1.6. There were weak correlations between patient's height or C7-IC and the level of analgesia. However a significant correlation existed between vertebral length measured from C7 to SH and the level of analgesia. CONCLUSIONS: It is concluded that vertebral length (C7-SH) provides a more meaningful approach to dose selection than height.
Analgesia ; Anesthesia, Spinal* ; Bupivacaine* ; Coccyx ; Humans ; Operating Tables

Isolated tuberculosis of the coccyx is extremely rare. A 35-year-old man presented with a 3-month history of coccygeal and gluteal pain. Computed tomography and magnetic resonance imaging revealed osseous destruction and a large enhancing mass involving the coccyx with anterior and posterior extension. Pathologic examination of the surgical specimen revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells consistent with tuberculosis. This case highlights the importance of considering tuberculosis as a diagnosis even though unusual sites are involved.
Coccyx ; Giant Cells ; Inflammation ; Magnetic Resonance Imaging ; Necrosis ; Tuberculosis

PURPOSE: The purpose of this study was to find an objective criteria to determine the position of normal anus in Korean children and to evaluate the clinical significance of anterior displacement of anus in children with constipation. METHODS: Three hundred and thirty-nine normal children and 24 children with idiopathic constipation represented the basis of this study. The position of the normal anus was defined by the anogenital index, which is the distance from the anus to the vagina or scrotum divided by the distance between the vagina or scrotum and coccyx. RESULTS: The mean anogenital index were 0.54 +/- 0.08 in normal male children, and 0.52 +/- 0.04 in male with constipation (P>0.05). The mean anogenital index were 0.43 +/- 0.08 in normal female children, and 0.42 +/- 0.07 in female with constipation (P>0.05). The anogenital index was very constant by age except for late male childhood. The anogenital index in female was significantly lower than in the male (P<0.001). There was no significant difference of the anogenital index between the normal and constipated groups. In both male and female groups with constipation, the anogenital index did not deviate from the mean, but one female patient had an anogenital index of 0.29. The ratio of the anterior displacement of the anus was 21 out of 339 (6.2%) in the normal group (SD<0.05), and 2 out of 24 (9%) in the constipated group (SD<0.05), and there was no difference (P>0.05). CONCLUSION: The anogenital index is an objective criteria to define the position of normal anus or anterior displacement of anus. There is no correlation between anterior displacement of the anus and idiopathic constipation.
Anal Canal ; Child* ; Coccyx ; Constipation* ; Female ; Humans ; Male ; Scrotum ; Vagina

Caudal regression syndrome is a rare congenital anomaly, which results from a developmental failure of thecaudal mesoderm during the fetal period. We present a case of caudal regression syndrome composed of a spectrum ofanomalies including sirenomelia, dysplasia of the lower lumbar vertebrae, sacrum, coccyx and pelvic bones,genitourinary and anorectal anomalies, and dysplasia of the lung, as seen during infantography and MR imaging.
Coccyx ; Ectromelia ; Lumbar Vertebrae ; Lung ; Magnetic Resonance Imaging ; Mesoderm ; Sacrum

A Morel-Lavallée lesion is a posttraumatic, closed internal degloving injury caused by shearing force abruptly separating the skin and superficial fascia from the deep fascia and creating a potential space. Blood, lymphatic fluid, and debris collect and fill the space. The most commonly affected sites are the thigh, knee, hip, and pelvic area, but the lesion can occur anywhere in the body. Among various treatments, surgical procedure is a good option if the lesion is chronic and a thick peripheral capsule has developed. We report an uncommon case of a chronic Morel-Lavallée lesion in the sacrococcygeal area, a rarely reported location, with an associated coccygeal fracture and dislocation.
Coccyx ; Dislocations ; Fascia ; Hip ; Knee ; Skin ; Subcutaneous Tissue ; Thigh

Several reports of coccygodynia have been confined to the causes, the methods of treatment, and the methods of radiological examination. As far as we know, there has been no previous study about the objective measurement of the coccyx. The purpose of this study was to find the possible cause of idiopathic coccygodynia by comparing the clinical and radiological differences between traumatic and idiopathic coccygodynia by innovative objective clinical and radiological measurements. Thirty-two patients with coccygodynia were evaluated retrospectively. We divided the patients into two groups. Group 1 consisted of 19 patients with traumatic coccygodynia and group 2 consisted of 13 patients with idiopathic coccygodynia. We reviewed medical records and checked age, sex distribution, symptoms, and treatment outcome in each group. We also reviewed coccyx AP and lateral views of plain radiological film and measured the number of coccyx segments and the intercoccygeal angle in each group. The intercoccygeal angle devised by the authors was defined as the angle between the first and last segment of the coccyx. We also checked the intercoccygeal angle in a normal control group, which consisted of 18 women and 2 men, to observe the reference value of the intercoccygeal angle. The outcome of treatment was assessed by a visual analogue scale based on the pain score. Statistical analysis was done with Mann-Whitney U test and Chi-square test. Group 1 consisted of 1 male and 18 female patients, while group 2 consisted of 2 male and 11 female patients. There were no statistically significant differences between the traumatic and idiopathic coccygodynia groups in terms of age (38.7 years versus 36.5 years), male/female sex ratio (1/18 versus 2/11), and the number of coccyx segments (2.9 versus 2.7). There were significant differences between the traumatic and idiopathic coccygodynia groups in terms of the pain score (pain on sitting: 82 versus 47, pain on defecation: 39 versus 87), the intercoccygeal angle (47.9 degree versus 72.2 degrees), and the satisfactory outcome of conservative treatment (47.4% versus 92.3%). The reference value of the intercoccygeal angle in the normal control group was 52.3 degrees, which was significantly different from that of the idiopathic group. In conclusion, the intercoccygeal angle of the idiopathic coccygodynia group was greater than that of the traumatic group and normal control group. Based on the results of this study, the increased intercoccygeal angle can be considered a possible cause of idiopathic coccygodynia. The intercoccygeal angle was a useful radiological measurement to evaluate the forward angulation deformity of the coccyx.
Adult ; Coccyx/radiography* ; Coccyx/physiopathology* ; Female ; Human ; Male ; Pain/therapy ; Pain/surgery ; Pain/radiography* ; Pain/physiopathology* ; Pain/etiology ; Spinal Injuries/complications ; Treatment Outcome

Anal incontinence following pelvic trauma, surgery, or neurologic disorders has significant medical and social implication. Both Chetwood in 1902 and Bistom in 1944 utilized coccygeal origin portion of the gluteus maximus muscle for the anal sphincter reconstruction. The gluteus maximus muscle is a broad, fan-shaped muscle with a wide origin from the ilium sacrum and coccyx and a narrow insertion along the iliotibial band of the lateral femur. Its blood supply is from the inferior gluteal artery and its innervation is from L-5, S-1 roots by means of the inferior gluteal nerve Incisions are placed at the inferior border of the ischial tuberosity. Subcutaneous tunnels are created about the rectum and gluteal and perirectal incisions. Two overacting slings are being created Their opposing pull creates sphincter or valve effect about the distal rectum. We have experienced 2 cases of irregular, deep soft tissue defects of the perianal region requiring muscle coverage with the gluteus maximus muscle overlapping slings. We think the use of the gluteus maximus muscle is one of the most useful method for reconstruction of the anal sphincter mechanism.
Anal Canal* ; Arteries ; Coccyx ; Femur ; Ilium ; Nervous System Diseases ; Rectum ; Sacrum