Background: Treatment of coccygodynia is still a challenging entity. Clear surgical selection criteria are still lacking. The aim of the investigation was to establish a novel radiological classification for surgical decision-making in coccygodynia cases.
Material And Methods: Retrospective analysis of standing and sitting X-rays of coccygodynia patients referred to a single centre from 2018 to 2020. The sacro-coccygeal angle (SCA), the intra-coccygeal angle (ICA) and the difference of the intervertebral disc height (∆IDH) were measured. All coccyges were distributed in subtypes and correlated with the patients' treatment.
Results: In total, 138 patients (female/male: 103/35) with a mean age of 45.6 ± 15.4 years were included in the study. In total, 49 patients underwent coccygectomy. Four different subtypes of displaced coccyges were identified: Type I with a non-segmented coccyx, anterior pivot, increased SCA and ICA from standing to sitting, ∆IDH = 1.0 ± 1.5 mm. Type II with a multisegmented coccyx, anterior pivot, increased SCA and ICA standing/sitting, ∆IDH = 1.1 ± 1.6 mm. Type III showed a posterior pivoted coccyx, negative SCA and ICA, ∆IDH = 0.6 ± 1.6 mm. Type IV is characterized by an anterior-posterior dissociation of the tail bone with a positive SCA, and the ICA shifted from a posterior to an anterior orientation. ∆IDH was - 0.6 ± 1.8 mm.
Conclusion: The presented radiological classification could help to facilitate the surgical decision-making for patients with displaced os coccyx. In addition, lateral and sitting X-rays were easy to perform and did not need unnecessary ionizing radiation like in CT scans and were more cost-effective than MRI investigations. The subtypes III and especially IV were more likely leading to surgery.
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http://dx.doi.org/10.1007/s00586-021-06971-5 | DOI Listing |
Surg Radiol Anat
December 2024
Department of Neurosurgery, Saitama Sekishinkai Hospital, 2-37-20 Irumagawa, Sayama, Saitama, 350-1305, Japan.
Purpose: To describe a case in which a right replaced posterior cerebral artery (PCA) was associated with an ipsilateral superior cerebellar artery (SCA) type persistent trigeminal artery (PTA) variant.
Methods: A 53-year-old man who had been diagnosed with chronic dissection of the left vertebral artery (VA) 4 months previously underwent follow-up magnetic resonance (MR) angiography using a 3-Tesla scanner.
Results: MR angiography showed a slightly dilated left VA at the terminal segment without interval change.
AJR Am J Roentgenol
December 2024
Department of Radiology, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Surg Neurol Int
August 2024
Department of Endovascular Neurosurgery, Saitama Medical University International Medical Center, Hidaka, Japan.
Background: Various degrees of thrombosis have been reported in patients with giant aneurysms. However, small, unruptured aneurysms rarely resolve spontaneously. Herein, we report a case of a small unruptured aneurysm in the clinoid segment (C3) of the left internal carotid artery (ICA) that showed almost complete occlusion at the 1-year follow-up.
View Article and Find Full Text PDFBr J Pharmacol
November 2024
Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.
Background And Purpose: Metabotropic glutamate receptor 1 (mGlu) is a promising therapeutic target for neurodegenerative CNS disorders including spinocerebellar ataxias (SCAs). Clinical reports have identified naturally-occurring mGlu mutations in rare SCA subtypes and linked symptoms to mGlu mutations. However, how mutations alter mGlu function remains unknown, as does amenability of receptor function to pharmacological rescue.
View Article and Find Full Text PDFRadiologie (Heidelb)
November 2023
Department of Biostatistics, Başkent University, Ankara, Turkey.
Background: Coccydynia is one of the most overlooked symptoms in daily clinical practice. Definitions for radiologic evaluation are controversial.
Objectives: We aimed to compare the morphology and morphometric measurements of the sacrococcygeal region with those of a healthy population to support radiologic decision-making.
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