Corrective Osteotomy and Fusion in an Adolescent Male with Painful Type V Coccyx Deformity: A Case Report

Coccydynia is a painful condition arising from the lowermost part of the vertebra with a prevalence of around 2.7%. Coccygectomy has emerged as an effective surgical method. Type V (retroverted and posteriorly angulated apex) is a rare variant (5%). Coccygeal osteotomy to correct the Type V deformit...

Full description

Saved in:
Bibliographic Details
Main Authors: Ujjwal K. Debnath, Shubhadip Chakraborty, Rakesh Prasad
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-05-01
Series:Indian Spine Journal
Subjects:
Online Access:https://doi.org/10.4103/isj.isj_92_24
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849703761149165568
author Ujjwal K. Debnath
Shubhadip Chakraborty
Rakesh Prasad
author_facet Ujjwal K. Debnath
Shubhadip Chakraborty
Rakesh Prasad
author_sort Ujjwal K. Debnath
collection DOAJ
description Coccydynia is a painful condition arising from the lowermost part of the vertebra with a prevalence of around 2.7%. Coccygectomy has emerged as an effective surgical method. Type V (retroverted and posteriorly angulated apex) is a rare variant (5%). Coccygeal osteotomy to correct the Type V deformity and alleviate pain has not been described previously in the literature. This study aims to report a unique case of Type V coccyx deformity with severe coccydynia. He underwent osteotomy, correction of Type V deformity, and fusion with a good outcome. A 15-year-old boy presented with severe pain in the tailbone region for 6 months. Clinical examination revealed puckering of skin at the tip of the protruding coccyx. The surgical technique is described. Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores were recorded preoperatively and at the final follow-up. He had a preoperative VAS score of 6 and an ODI score of 24. X-ray imaging revealed a retroverted coccyx (with posterior angulation) and a magnetic resonance imaging scan suggested an elongated coccyx with outward concavity (posterior angulation). The retroverted coccyx was corrected by osteotomy and a small triangular piece of bone graft was placed at the sacrococcygeal disc space after removing the disc. Two 3.5 mm cortical screws on either side were used to transfix the coccyx to the distal sacrum. Clinical and radiological improvements were observed every 6 months. At a follow-up of 3 years, he remains pain-free with a VAS score of 0. His ODI score was 0. This unique case of corrective osteotomy and fusion of the Type V coccygeal deformity to a normal angulation resulted in a pain-free life in an adolescent. This type of corrective osteotomy and fusion has not been described before.
format Article
id doaj-art-4ea7a2371e704b90930d207e98c541b8
institution DOAJ
issn 2589-5079
2589-5087
language English
publishDate 2025-05-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Indian Spine Journal
spelling doaj-art-4ea7a2371e704b90930d207e98c541b82025-08-20T03:17:08ZengWolters Kluwer Medknow PublicationsIndian Spine Journal2589-50792589-50872025-05-018216316610.4103/isj.isj_92_24Corrective Osteotomy and Fusion in an Adolescent Male with Painful Type V Coccyx Deformity: A Case ReportUjjwal K. DebnathShubhadip ChakrabortyRakesh PrasadCoccydynia is a painful condition arising from the lowermost part of the vertebra with a prevalence of around 2.7%. Coccygectomy has emerged as an effective surgical method. Type V (retroverted and posteriorly angulated apex) is a rare variant (5%). Coccygeal osteotomy to correct the Type V deformity and alleviate pain has not been described previously in the literature. This study aims to report a unique case of Type V coccyx deformity with severe coccydynia. He underwent osteotomy, correction of Type V deformity, and fusion with a good outcome. A 15-year-old boy presented with severe pain in the tailbone region for 6 months. Clinical examination revealed puckering of skin at the tip of the protruding coccyx. The surgical technique is described. Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores were recorded preoperatively and at the final follow-up. He had a preoperative VAS score of 6 and an ODI score of 24. X-ray imaging revealed a retroverted coccyx (with posterior angulation) and a magnetic resonance imaging scan suggested an elongated coccyx with outward concavity (posterior angulation). The retroverted coccyx was corrected by osteotomy and a small triangular piece of bone graft was placed at the sacrococcygeal disc space after removing the disc. Two 3.5 mm cortical screws on either side were used to transfix the coccyx to the distal sacrum. Clinical and radiological improvements were observed every 6 months. At a follow-up of 3 years, he remains pain-free with a VAS score of 0. His ODI score was 0. This unique case of corrective osteotomy and fusion of the Type V coccygeal deformity to a normal angulation resulted in a pain-free life in an adolescent. This type of corrective osteotomy and fusion has not been described before.https://doi.org/10.4103/isj.isj_92_24coccydyniacoccygectomycoccyx deformityretroverted coccyx
spellingShingle Ujjwal K. Debnath
Shubhadip Chakraborty
Rakesh Prasad
Corrective Osteotomy and Fusion in an Adolescent Male with Painful Type V Coccyx Deformity: A Case Report
Indian Spine Journal
coccydynia
coccygectomy
coccyx deformity
retroverted coccyx
title Corrective Osteotomy and Fusion in an Adolescent Male with Painful Type V Coccyx Deformity: A Case Report
title_full Corrective Osteotomy and Fusion in an Adolescent Male with Painful Type V Coccyx Deformity: A Case Report
title_fullStr Corrective Osteotomy and Fusion in an Adolescent Male with Painful Type V Coccyx Deformity: A Case Report
title_full_unstemmed Corrective Osteotomy and Fusion in an Adolescent Male with Painful Type V Coccyx Deformity: A Case Report
title_short Corrective Osteotomy and Fusion in an Adolescent Male with Painful Type V Coccyx Deformity: A Case Report
title_sort corrective osteotomy and fusion in an adolescent male with painful type v coccyx deformity a case report
topic coccydynia
coccygectomy
coccyx deformity
retroverted coccyx
url https://doi.org/10.4103/isj.isj_92_24
work_keys_str_mv AT ujjwalkdebnath correctiveosteotomyandfusioninanadolescentmalewithpainfultypevcoccyxdeformityacasereport
AT shubhadipchakraborty correctiveosteotomyandfusioninanadolescentmalewithpainfultypevcoccyxdeformityacasereport
AT rakeshprasad correctiveosteotomyandfusioninanadolescentmalewithpainfultypevcoccyxdeformityacasereport