Coccygectomy, tailbone pain, back and coccydynia

Dynamic coccyx x-ray

A dynamic coccyx x-ray is crucial to a successful diagnosis of coccydynia that will lead to a potential subsequent coccygectomy. If you have a sore tailbone and the chronic pain simply does not go away, you need to insist on a dynamic coccyx xray to confirm that your pain in your tailbone is in fact coccydynia, a fractured coccyx or even a broken coccyx.

How is a dynamic coccyx xray different than a regular xray? The difference between a regular x-ray and dynamic one is that you will need to take a picture in more than one position with dynamic as opposed to a single picture with a standard xray. The radiologist will take multiple pictures of your coccyx, usually one sitting and one standing, in order to check the mobility of the coccyx if in fact there is some damage or hypermobility.

The dynamic coccyx x-ray is a method developed by Dr Jean-Yves Maigne. He discovered that when his method was used to determine coccyx injury that he could give a firm diagnosis of the cause of coccyx pain in seventy percent of cases. Part of the challenge with this methodology is that it is still not very widely used, at least as much as it could be in coccydynia diagnosis. If more patients insisted that their doctors used this method if exploration they would find a greater success in diagnosis in a more timely manner.

Here is how getting a dynamic coccyx xray can be beneficial:

  • it will show which joint is dislocating which will allowing the doctor to give a corticosteroid injection in the proper place more directly. To ensure proper application of this injection, a doctor will need to do the injection under flouroscopy, a continuous x-ray which allows the doctor to see where the needle is going.
  • if a joint is moving abnormally and the previously mentioned corticosteroid injection does not help with the chronic coccyx pain, coccyx removal surgery (c0ccygectomy) will most likely need to be done. If the instability is at the joint between the coccyx and the sacrum, the whole of the coccyx is removed. If not, then only those parts of the coccyx that are unstable need to be removed.
  • if the dynamic coccyx x-ray does not show abnormal movement of the coccyx then a coccygectomy likely won’t be successful.

If you are experiencing constant coccyx pain, it is recommend that your ask for a dynamic coccyx x-ray. Most doctors are still fairly new to the procedure, and if your doctor refuses to do one for you, get a second opinion and don’t stop until you get what you are looking for. In our experience, we had to continue asking until we got what we wanted. We ultimately ended up with a diagnosis of coccydynia and subsequently had a coccygectomy.

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