No Surgical Hardware for Tailbone Pain

Sometimes patients ask me whether tailbone pain (coccyx pain) can be treated by placing surgical hardware into or onto the tailbone to stabilize any instability of the tailbone.

At first consideration, this is a reasonable thought.

  1. Firstly, unstable joints of the tailbone are one of the most common causes of tailbone pain (and this diagnosis is very frequently missed if tailbone x-rays are not done while the patient is sitting down).
  2. Secondly, unstable joints and bones in other parts of the body are often treated by inserting a metal screw, pin, or rod, or by attaching a metal plate that spans across the unstable area in order to stabilize that location.

However, the tailbone is different than many other sites. There is no well-established surgical procedure to put hardware into or onto the coccyx to stabilize it. 

But there is ONE single case where a surgical pin was used:  

  • This was only tried in ONE single patient, in South Korea.
  • A 31 year-old woman slipped and fell onto her coccyx, causing anterior dislocation at the sacrococcygeal joint.
  • Surgeons put in a surgical pin:
    • they inserted a thin (2.4 mm diameter) wire/pin into the coccyx to treat the dislocation.
  • This surgery was performed VERY soon after the injury.
    • Specifically, it was done just eight hours after the tailbone injury.
    • So the surgery was done the VERY SAME DAY as the injury.
    • The VERY soon timing of the surgery raises multiple questions:
      • Would the patient’s pain have improved just as well without the surgery, just by normal, natural recovery?
      • What would be the criteria to justify doing surgery so soon, when data and clinical experience shows that MOST patients with tailbone injuries resolve over time WITHOUT surgery?
      • Would any similar surgery have any role in patients who did not have the surgery done on the same day as their injury?
  • Published: Joystick reduction and percutaneous pinning for an acutely anteriorly dislocated coccyx: a case report. Kim WY, et al. J Orthop Trauma. 2004.

 

Beware surgical cement

  • There was a single case report presented at a conference years ago about a doctor who injected some surgical cement into a patient’s coccyx region.
  • But I don’t think there was ever any follow-up after the conference in terms of how the eventual outcome was.
  • Also, I don’t think they ever published it as a medical journal article.
  • I did inherit one other/different patient who had undergone an injection of surgical cement and she reported being MUCH worse for having undergone the injection. It was sort of a mess, because now the cement blocked the areas where typical injections would be tried. Also, any surgical treatment was going to need to remove not only the focal area of the coccyx, but also was going to need to remove the extended, larger area of the cement.
If you have thoughts, comments, or experiences regarding surgical hardware at the coccyx, or regarding cement injections for tailbone pain… Please post your comments below! 
Regarding complications and side-effects from coccygectomy (surgical removal of the tailbone), please click on the links below:

 

Patrick Foye, M.D.

Founder and Director at The Tailbone Pain Center
Patrick Foye, M.D.
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Patrick Foye, M.D.

Founder and Director at Tailbone Pain Center
Dr. Foye is an expert at treating tailbone pain (coccyx pain).

His personable, private-practice office is located on a modern, renowned, academic medical school campus, at Rutgers New Jersey Medical School.

For an appointment, call 973-972-2802.

http://tailbonedoctor.com/
Patrick Foye, M.D.
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