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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(03): 324-328
DOI: 10.4103/ijri.IJRI_294_16
Musculoskeletal Radiology

Ganglion impar block in patients with chronic coccydynia

Nitesh Gonnade
Department of Physical Medicine and Rehabilitation, AIIMS, Jodhpur, Rajasthan, India
,
Neeraj Mehta
Department of Diagnostic and Interventional Radiology, AIIMS, Jodhpur, Rajasthan, India
,
Pushpinder Singh Khera
Department of Diagnostic and Interventional Radiology, AIIMS, Jodhpur, Rajasthan, India
,
Dewesh Kumar
Department of Community and Family Medicine, AIIMS, Jodhpur, Rajasthan, India
,
Rengarajan Rajagopal
Department of Diagnostic and Interventional Radiology, AIIMS, Jodhpur, Rajasthan, India
,
Pramod Kumar Sharma
Department of Pharmacology, AIIMS, Jodhpur, Rajasthan, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Introduction: Coccydynia refers to pain in the terminal segment of the spinecaused by abnormal sitting and standing posture. Coccydynia is usually managed conservatively, however in nonresponsive patients, ganglion impar block is used as a good alternate modality for pain relief. This article studies the effect of ganglion impar block in coccydynia patients who were not relieved by conservative management. Materials and Methods: The study was carried out at the pain clinic in the departments of Physical Medicine and Rehabilitation and Radiology in a tertiary centre in India.It was a prospective hospital-based study, in which 35 patients with coccydynia were considered for fluoroscopy-guided trans-sacro-coccygeal ganglion impar block. The outcome assessment was done using Numerical Rating Scale (NRS) and Oswestry Disability Index (ODI) scores for a follow-up period of 6 months. Of the 35 patients, 4 were lost to follow-up. Analysis was done usingthe data from the remaining 31 patients. Results: The mean age of the patients suffering from chronic coccydynia was 42.9 ± 8.39 years, and patients' age range was 28–57 years. The mean score of NRS and ODI before the procedure was 7.90 ± 0.16 and 48.97 ± 1.05, respectively. The interquartile range (IQR) of NRS score remained almost unchanged during pre and postprocedure, however, IQR of ODI varied during the pre and post procedural events. The NRS and ODI scores immediately after the procedure decreased drastically showing significant pain relief in patients, and the difference of scores till the end of study was statistically significant. Conclusion: This study recommends the trans-sacro-coccygeal “needle inside needle” technique for local anesthetic block of the ganglion impar for pain relief in patients with coccydynia. This should be integrated with rehabilitative measures including ergonomical modification for prolonging pain free period.

Keywords

Coccydynia - ganglion impar block - NRS score - ODI score


Publication History

Article published online:
27 July 2021

© 2017. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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