Skip to main content
Top
Published in: BMC Anesthesiology 1/2020

Open Access 01-12-2020 | Analgesics in Dentistry | Research article

Retrospective evaluation of pain in patients with coccydynia who underwent impar ganglion block

Authors: Ozlem Sagir, Hafize Fisun Demir, Fatih Ugun, Bulent Atik

Published in: BMC Anesthesiology | Issue 1/2020

Login to get access

Abstract

Background

We aimed to evaluate pain scores one year after impar ganglion block in patients with coccydynia who did not benefit from conservative treatment.

Methods

The medical records of 29 patients with coccydynia were reviewed. Patients who were referred to the algology clinic and underwent impar ganglion blocks were retrospectively evaluated. Demographic data, time to the onset of pain, causes of pain, X-ray findings, administered invasive procedures, and visual analog scale (pain) scores were recorded.

Results

A total of 29 patients were included in the study, 10 males (34%) and 19 females (66%). The average age and body mass index were 53.45 ± 9.6 and 29.55 ± 4.21 respectively. In 21 patients, the onset of pain was associated with trauma. Nineteen patients (65.5%) had anterior coccygeal angulation. The average visual analog scale score before undergoing an impar ganglion block was 7.4 ± 1. After the procedure, the scores at < 3 months, 3–6 months and 6 months-1 year follow-up intervals were significantly lower (p < 0.05). Furthermore, visual analog scale scores at the 3–6 months and 6 months-1 year periods were significantly lower in patients who received diagnostic blocks plus pulse radiofrequency thermocoagulation than in patients who underwent a diagnostic block only.

Conclusions

The impar ganglion block provides effective analgesia without complications in patients with coccydynia. Pulse radiofrequency thermocoagulation combined with a diagnostic block prolongs the analgesic effect of the procedure.
Literature
1.
go back to reference Patijn J, Janssen M, Hayek S, Mekhail N, Zundert JV, Kleef MV. Coccygodynia. Pain Pract. 2010;10:554–9.CrossRef Patijn J, Janssen M, Hayek S, Mekhail N, Zundert JV, Kleef MV. Coccygodynia. Pain Pract. 2010;10:554–9.CrossRef
2.
go back to reference Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014;14:84–7.PubMedPubMedCentral Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014;14:84–7.PubMedPubMedCentral
3.
go back to reference Nathan ST, Fisher BE, Roberts CS. Coccydynia: a review of pathoanatomy, aetiology, treatment and outcome. J Bone Joint Surg Br. 2010;92:1622–7.CrossRef Nathan ST, Fisher BE, Roberts CS. Coccydynia: a review of pathoanatomy, aetiology, treatment and outcome. J Bone Joint Surg Br. 2010;92:1622–7.CrossRef
4.
go back to reference Maigne JY, Doursounian L, Chatellier G. Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine (Phila Pa 1976). 2000;25:3072–9.CrossRef Maigne JY, Doursounian L, Chatellier G. Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine (Phila Pa 1976). 2000;25:3072–9.CrossRef
5.
go back to reference Peng P, Narouze S. Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy and procedures. Part I: non-axial structures. Reg Anesth Pain Med. 2009;34:458–74.CrossRef Peng P, Narouze S. Ultrasound-guided interventional procedures in pain medicine: a review of anatomy, sonoanatomy and procedures. Part I: non-axial structures. Reg Anesth Pain Med. 2009;34:458–74.CrossRef
6.
go back to reference Elkhashab Y, Ng A. A review of current treatment options for Coccygodynia. Curr Pain Headache Rep. 2018;19:22–8.CrossRef Elkhashab Y, Ng A. A review of current treatment options for Coccygodynia. Curr Pain Headache Rep. 2018;19:22–8.CrossRef
7.
go back to reference Oh CS, Chung IH, Ji HJ, Yoon DM. Clinical implications of topographic anatomy on the ganglion impar. Anesthesiology. 2004;101:249–50.CrossRef Oh CS, Chung IH, Ji HJ, Yoon DM. Clinical implications of topographic anatomy on the ganglion impar. Anesthesiology. 2004;101:249–50.CrossRef
8.
go back to reference Reig E, Abejón D, del Pozo C, Insausti J, Contreras R. Thermocoagulation of the ganglion impar or ganglion of Walther: description of a modified approach. Preliminary results in chronic, nononcological pain. Pain Pract. 2005;5:103–10.CrossRef Reig E, Abejón D, del Pozo C, Insausti J, Contreras R. Thermocoagulation of the ganglion impar or ganglion of Walther: description of a modified approach. Preliminary results in chronic, nononcological pain. Pain Pract. 2005;5:103–10.CrossRef
9.
go back to reference Agarwal-Kozlowski K, Lorke DE, Habermann CR, Amm Esch JS, Beck H. CT-guided blocks and neuroablation of the ganglion impar (Walther) in perineal pain: anatomy, technique, safety and efficacy. Clin J Pain. 2009;25:570–6.CrossRef Agarwal-Kozlowski K, Lorke DE, Habermann CR, Amm Esch JS, Beck H. CT-guided blocks and neuroablation of the ganglion impar (Walther) in perineal pain: anatomy, technique, safety and efficacy. Clin J Pain. 2009;25:570–6.CrossRef
10.
go back to reference Lin CS, Cheng JK, Hsu YW, Chen CC, Lao HC, Huang CJ, et al. Ultrasound-guided ganglion impar block: a technical report. Pain Med. 2010;11:390–4.CrossRef Lin CS, Cheng JK, Hsu YW, Chen CC, Lao HC, Huang CJ, et al. Ultrasound-guided ganglion impar block: a technical report. Pain Med. 2010;11:390–4.CrossRef
11.
go back to reference Postacchini F, Massobrio M. Idiopathic coccygodynia. J Bone Joint Surg Am. 1983;65A:1116–24.CrossRef Postacchini F, Massobrio M. Idiopathic coccygodynia. J Bone Joint Surg Am. 1983;65A:1116–24.CrossRef
12.
go back to reference Fogel GR, Cunningham PY, Esses SI. Coccygodynia: evaluation and management. J Am Acad Orthop Surg. 2004;12:49–54.CrossRef Fogel GR, Cunningham PY, Esses SI. Coccygodynia: evaluation and management. J Am Acad Orthop Surg. 2004;12:49–54.CrossRef
13.
go back to reference Maigne JY, Pigeau I, Aguer N, Doursounian L, Chatellier G. Chronic coccydynia in adolescents. A series of 53 patients. Eur J Phys Rehabil Med. 2011;47:245–51.PubMed Maigne JY, Pigeau I, Aguer N, Doursounian L, Chatellier G. Chronic coccydynia in adolescents. A series of 53 patients. Eur J Phys Rehabil Med. 2011;47:245–51.PubMed
14.
go back to reference Gunduz OH, Sencan S, Kenis-Coskun O. Pain relief due to Transsacrococcygeal ganglion Impar block in chronic Coccygodynia: a pilot study. Pain Med. 2015;16:1278–81.CrossRef Gunduz OH, Sencan S, Kenis-Coskun O. Pain relief due to Transsacrococcygeal ganglion Impar block in chronic Coccygodynia: a pilot study. Pain Med. 2015;16:1278–81.CrossRef
15.
go back to reference Pennekamp PH, Kraft CN, Stütz A, Wallny T, Schmitt O, Diedrich O. Coccygectomy for coccygodynia: does pathogenesis matter? J Trauma. 2005;59:1414–9.CrossRef Pennekamp PH, Kraft CN, Stütz A, Wallny T, Schmitt O, Diedrich O. Coccygectomy for coccygodynia: does pathogenesis matter? J Trauma. 2005;59:1414–9.CrossRef
16.
go back to reference Capar B, Akpinar N, Kutluay E, Müjde S, Turan A. Coccygectomy in patients with coccydynia [in Turkish]. Acta Orthop Traumatol Turc. 2007;41:277–80.PubMed Capar B, Akpinar N, Kutluay E, Müjde S, Turan A. Coccygectomy in patients with coccydynia [in Turkish]. Acta Orthop Traumatol Turc. 2007;41:277–80.PubMed
17.
go back to reference Trollegaard AM, Aarby NS, Hellberg S. Coccygectomy: an effective treatment option for chronic coccydynia: retrospective results in 41 consecutive patients. J Bone Joint Surg Br. 2010;92:242–5.CrossRef Trollegaard AM, Aarby NS, Hellberg S. Coccygectomy: an effective treatment option for chronic coccydynia: retrospective results in 41 consecutive patients. J Bone Joint Surg Br. 2010;92:242–5.CrossRef
18.
go back to reference Gonnade N, Mehta N, Khera PS, Kumar D, Rajagopal R, Sharma PK. Ganglion impar block in patients with chronic coccydynia. Indian J Radiol Imaging. 2017;27:324–8.CrossRef Gonnade N, Mehta N, Khera PS, Kumar D, Rajagopal R, Sharma PK. Ganglion impar block in patients with chronic coccydynia. Indian J Radiol Imaging. 2017;27:324–8.CrossRef
19.
go back to reference Kırcelli A, Demirçay E, Özel Ö, Çöven I, Işık S, Civelek E, et al. Radiofrequency Thermocoagulation of the ganglion Impar for Coccydynia management: long-term effects. Pain Pract. 2019;19:9–15.CrossRef Kırcelli A, Demirçay E, Özel Ö, Çöven I, Işık S, Civelek E, et al. Radiofrequency Thermocoagulation of the ganglion Impar for Coccydynia management: long-term effects. Pain Pract. 2019;19:9–15.CrossRef
20.
go back to reference Foye PM. Coccydynia: tailbone pain. Phys Med Rehabil Clin N Am. 2017;28:539–49.CrossRef Foye PM. Coccydynia: tailbone pain. Phys Med Rehabil Clin N Am. 2017;28:539–49.CrossRef
Metadata
Title
Retrospective evaluation of pain in patients with coccydynia who underwent impar ganglion block
Authors
Ozlem Sagir
Hafize Fisun Demir
Fatih Ugun
Bulent Atik
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2020
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-020-01034-6

Other articles of this Issue 1/2020

BMC Anesthesiology 1/2020 Go to the issue