What is a Coccygectomy?

So, what exactly is a coccygectomy? If you’re considering having this tailbone surgery, you’ve undoubtedly arrived at this decision after much pain and contemplation. A coccygectomy is basically a tailbone surgery that includes the removal of all or some of the coccyx due to injury. The coccyx may have been injured in a variety of ways,  including: sports, falling and child birth. Once the tailbone pain becomes unbearable and your doctor has exhausted all avenues of pain management, you will probably be diagnosed with coccydynia and refered to a specialist.

    Should I have a coccygectomy?

    The first question one must ask themselves before they move ahead with a coccygectomy is “should I have my coccyx removed”? This, of course, is not an easy question to answer and should not be entered into lightly.

    Once you decide that a coccygectomy is your last option, you must ensure that your doctor or specialist has a lot of experience with the coccyx and/or coccygectomies. This surgery is in a very sensitive area with the potential of serious complications, so not just any surgeon is able to perform the surgery.

    A surgeon will consider you a good candidate for surgery if:

    • the pain you’re experiencing is in the area of the coccyx and tail bon and is caused or aggravated by sitting. The doctor may test the area by injecting a local anesthetic to ensure that the coccyx is the source of your pain.
    • any other treatable diseases/conditions that could potentially cause the pain have been ruled out.
    • other treatments, such as corticosteroid injections or prolotherapy, have not provided sustained relief.
    • different surgeons have different methods of deciding if you are a good candidate for coccyx surgery or not. Some surgeons feel that anyone who has coccyx pain because of a direct injury to be a good candidate for a coccygectomy. Others will conclude that getting temporary relief from the pain with a corticosteriod injection shows you are a good candidate. The best indication of a good candidate for a coccygecomty is a coccyx which has been shown to be unstable on the basis of a dynamic sit/stand x-ray.

    Once it has been determined by a surgeon that you’ll be a good candidate for the surgery, you will then need to make the decision to go through with it. Although it is a scary proposition with the potential of no relief from your pain, the thought of living a pain free life may be just enough of a push to help you make the decision.

    Here are a few pro’s and con’s for having the surgery:

    Pro’s

    1. If you meet the criteria above and your surgeon feel you to be a good candidate and your surgeon has plenty of experience and success with this operation, surgery is likely to substantially reduce or eliminate your pain.
    2. Most people who have had their coccyx removed are happy they did so and regain their previous quality of life.

    Con’s

    1. In the short term during recovery, the surgery will probably increase your pain and you will be out of action for weeks and potentially months. Full recovery could take up to a year.
    2. You may potentially be one of the minority of people who receive little or no benefit from the operation at all. Although this is a slim chance, the possibility of an unsuccessful surgery is always there.
    3. Analysis of published research suggests that 1-2% of patients tht have had a coccygectomy may actually have increased pain after surgery.