article · Global Spine Journal
This study examined the anatomical and structural features of the sacrococcygeal region in people experiencing unexplained tailbone pain, known as idiopathic coccydynia. Researchers analysed magnetic resonance imaging scans from sixty affected patients and compared them to scans from sixty control individuals. The assessment evaluated various anatomical characteristics, including bone shapes, joint fusion, bone spurs, and curvature measurements. Several distinct differences emerged between the groups. Patients with coccydynia displayed a higher prevalence of type II coccyx structures, bony spicules, and partial dislocations of the intercoccygeal joints. In contrast, fusion of the sacrococcygeal joint was less frequent in the patient group. Furthermore, individuals with coccydynia exhibited longer curved measurements of the sacrococcygeal region, a reduced sacrococcygeal curvature index, and a lower sacral angle. Certain sex-specific anatomical variations were also identified in curvature and joint angles.
Idiopathic coccydynia causes disabling tailbone pain without an obvious trauma or cause. By identifying specific anatomical traits and joint abnormalities through magnetic resonance imaging, this work helps clinicians better understand the structural factors predisposing individuals to the condition, potentially improving diagnostic assessments for patients with chronic pain.
The findings could inform the development of clinical diagnostic protocols, imaging assessment criteria, or radiological software tools that help spine specialists and radiologists identify anatomical risk factors for tailbone pain. Because this is a retrospective case-control observational study, any practical application remains at an early, exploratory stage, requiring prospective clinical validation before integration into routine diagnostic devices or software.
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Study Design: Retrospective case-control study. Objectives: To evaluate the sacrococcygeal morphologic and morphometric features in idiopathic coccydynia using magnetic resonance imaging (MRI). Methods: MRI scans from 60 patients with idiopathic coccydynia were compared with scans of 60 controls. Assessment of coccygeal morphology included coccygeal segmentation, coccygeal types, bony spicules, sacrococcygeal joint fusion, and intercoccygeal joint fusion and subluxation. Morphometric parameters included coccygeal straight and curved lengths, coccygeal curvature index, sacrococcygeal and intercoccygeal joint angles, sacral straight and curved lengths, sacral curvature index, sacral angle, sacrococcygeal straight and curved lengths, sacrococcygeal curvature index, and sacrococcygeal angle. Results: The coccydynia group included 28 males and 32 females, with a mean age of 36.1 years. Type II coccyx and bony spicules were more common in coccydynia, P = 0.003 and 0.01, respectively. Sacrococcygeal joints were fused less commonly in coccydynia, P = 0.02. Intercoccygeal joint subluxation was more common in coccydynia, P = 0.007. The sacral angle was lower in coccydynia, P = 0.01. The sacrococcygeal curved length was higher in coccydynia, P < 0.001. The sacrococcygeal curvature index was lower coccydynia, P < 0.001. In females only, the coccygeal curvature index was lower in coccydynia patients, P = 0.04. In males only, the intercoccygeal angle was lower in coccydynia patients, P = 0.02. Conclusions: Type II coccyx, bony spicules, intercoccygeal joint subluxation were more common, and sacrococcygeal joint fusion was less common in coccydynia patients. Sacral angle and sacrococcygeal curvature index were lower, while sacrococcygeal curved length was higher in coccydynia patients. Level of Evidence: Level 3. Case-control study.
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DOI: 10.1177/2192568221993791
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