Coccygectomy Using a Transverse Skin Incision: A Case series with Technical Note

Introduction: Coccygectomy is an effective treatment option for chronic refractory coccydynia, but it is often associated with wound complications including wound dehiscence and surgical site infections. To mitigate these issues, different surgical approaches have been explored, including paramedian incisions, paramedian curvilinear incisions and Z-plasty techniques. We describe a novel technique with the use of a transverse skin incision for coccygectomy and assess the clinical outcomes and patient satisfaction associated with this approach.

Methods: Patients suffering from refractory coccydynia, resistant to conservative therapies, underwent coccygectomy using a transverse skin incision between 2011 and 2023. Demographic data for all patients were collected from electronic medical records retrospectively. The primary outcome measure assessed the postoperative wound healing. Secondary outcomes included the evaluation of Visual Analog Scale (VAS) pain scores and overall patient satisfaction.

Results: 16 patients(3 males and 13 females) fulfilled the inclusion criteria. The mean age of the study population was 29.5 years (range 7-55 years). 2 patients (12.5%) experienced wound dehiscence that required re-suturing and 1(6.25%) patient had a superficial wound infection which was treated with oral antibiotics. None of the patients had any deep infection. The mean VAS score improved from 8.5 ± 1.5 (pre-operatively) to 3.2 ± 2.8 (post-operatively) (p < 0.05). 13 patients had an excellent outcome after the procedure while 3 had a fair outcome.

Conclusion : A transverse skin incision appears promising as an alternative to the conventional midline incision, potentially lowering the incidence of delayed wound healing and surgical site infections.