Coccygectomy: Current Views and Controversies

most commonly affected between their late 20s and early 50s.8,9 Causes of coccygodynia include direct trauma (59.1%); idiopathic causes (30.9%); childbirth (8.1%); or recent rectal surgery, lumbar surgery, or epidural injections (1.9%).8 Trauma secondary to falls or childbirth within the month before the onset of symptoms has been shown to be associated with coccygeal hypermobility.5 Maigne and colleagues5 proposed that body mass index greater than 27.4 kg/m2 in women and 29.4 kg/m2 in men increases the risk for development of idiopathic or posttraumatic coccygodynia. This is due to the diminished pelvic rotation in obese patients. The coccyx juts out more posteriorly while sitting,5 which increases the exposure to pressure and increases the risk for coccygeal subluxation. In some cases, coccygodynia can be related to tumors such as chordoma, giant cell tumor, intradural schwannoma, perineural cyst, and intraosseous lipoma.10-12