{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:27:22Z","timestamp":1777465642766,"version":"3.51.4"},"reference-count":30,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2022,2,9]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coccydynia has many causes, including fracture, subluxation, and hypermobility of sacrococcygeal segments. Existing treatments are limited in their effectiveness. Coccygeoplasty (CP) is a relatively new, minimally invasive treatment that appears to address this difficult clinical challenge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To describe clinical results at the time of the procedure and at 3- and 12-months' follow-up of patients with coccydynia related to subluxation and coccyx hypermobility treated with the CP technique. Additionally, to determine if there is any correlation between the final imaging and clinical results at 3- and 12-months' follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospectively maintained database was used, and all patients who underwent CP for chronic coccydynia between January 2005 and October 2018 were retrospectively reviewed. All the patients had painful hypermobility (greater than 25\u00b0) with anterior flexion confirmed on radiological imaging. Alternative causes of coccydynia were excluded using CT and MRI. Procedures were performed under local anesthesia with combined fluoroscopic and CT guidance. Clinical follow-up was performed at two time points: 3 and 12 months after treatment using the Visual Analogue Scale (VAS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twelve patients were treated in a single center. No procedural complications occurred. At 3- and 12-months' follow-up, the majority (75%) of patients had significantly lower VAS scores than at baseline, with mean changes of 3.5 and 4.9, respectively. There was no pain recurrence at 12 months and just one patient had no improvement of the pain. Follow-up CT images confirmed fixation of the sacrococcygeal bone segments in nine patients; however, no correlation was found between final imaging results and clinical outcome (p=0.1).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with refractory painful coccyx subluxation and hypermobility undergoing CP have a favorable clinical response at 3- and 12-months' follow-up. Further studies are required to validate this technique and to identify predictors of treatment response. Coccygeoplasty may be considered a reasonable alternative to coccygectomy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2021-018149","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T01:44:56Z","timestamp":1658972696000},"page":"82-85","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Coccygeoplasty: preliminary experience with this new alternative treatment of refractory coccydynia in patients with coccyx hypermobility"],"prefix":"10.1136","volume":"15","author":[{"given":"Luigi","family":"Manfre","sequence":"first","affiliation":[{"name":"Department of Radiology, IOM Mediterranean Oncology Institute, Viagrande, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4935-5921","authenticated-orcid":false,"given":"In\u00eas","family":"Gil","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Centro Hospitalar do Algarve EPE, Faro, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiago","family":"Baptista","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Oxford University Hospitals NHS Trust, Oxford, UK"},{"name":"Department of Neuroradiology, Centro Hospitalar de Lisboa Central, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Calv\u00e3o Pires","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aldo Eros","family":"de Vivo","sequence":"additional","affiliation":[{"name":"Department of Radiology, IOM Mediterranean Oncology Institute, Viagrande, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvador","family":"Masala","sequence":"additional","affiliation":[{"name":"Department of Diagnosis Imaging Interventional Radiology and Clinical Pathology, Ospedale San Giovanni Battista, Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronil V","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Monash Health, Clayton, Victoria, Australia"},{"name":"Department of Image, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gennaro","family":"D'Anna","sequence":"additional","affiliation":[{"name":"Department of Radiology, IRCCS Istituto Clinico Humanitas, Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9594-8798","authenticated-orcid":false,"given":"Joshua A","family":"Hirsch","sequence":"additional","affiliation":[{"name":"NeuroEndovascular Program, Massachusetts General Hospital, Boston, Massachusetts, 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