Abstract
Aim: The morphology of the coccyx varies. This variety makes it difficult to understand the radiologic pathologies in idiopathic coccydynia. This study aimed to examine the coccyx morphology in Turkish society in order to establish a set of societal reference values.
Method: By retrospective analysis of computed tomography scans of one thousand adults, the following were evaluated: number of coccygeal segments, type of coccyxes, sacrococcygeal and intercoccygeal joint fusion, coccygeal spicules, sacrococcygeal straight length, sacrococcygeal and intercoccygeal curvature angles and lateral deviation of the coccyx tip.
Results:The most common number of coccygeal segments was determined to be four, and the most common coccyx type was II. Sacrococcygeal fusion was observed in 69.5%, and intercoccygeal fusion in 83.6%. Coccygeal spicule was seen in 3.7% of the cases. The mean sacrococcygeal straight length was 34.3 mm in males and 32.2 mm in females; this length was also significantly higher in the male group (p<0.001). The mean sacrococcygeal curvature angle was 108.8° in females and 112.7° males; this angle was significantly wider in the male group (p<0.001).
Conclusion: This study, conducted in asymptomatic Turkish individuals, is the most comprehensive study to date and can be used as a “set of societal reference values” in future studies with symptomatic cases to determine the societal morphology of the coccyx and the etiology of coccydynia.
Keywords
Project Number
yok
References
- 1. Foye PM. Coccydynia: Tailbone Pain. Phys Med Rehabil Clin N Am. 2017;28(3):539–49. doi: 10.1016/j.pmr.2017.03.006.
- 2. Nathan ST, Fisher BE, Roberts CS. Coccydynia: a review of pathoanatomy, aetiology, treatment and outcome. J Bone Joint Surg Br. 2010;92(12):1622–7. doi: 10.1302/0301-620X.92B12.25486.
- 3. Lee J-Y, Gil Y-C, Shin K-J, Kim J-N, Joo S-H, Koh K-S, et al. An Anatomical and Morphometric Study of the Coccyx Using Three-Dimensional Reconstruction. Anat Rec (Hoboken). 2016;299(3):307–12. doi: 10.1002/ar.23300.
- 4. Maigne JY, Pigeau I, Roger B. Magnetic resonance imaging findings in the painful adult coccyx. Eur Spine J. 2012;21(10):2097-104. doi: 10.1007/s00586-012-2202-6.
- 5. Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014;14(1):84–7. PMID: 24688338
- 6. 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(23):3072–9. doi: 10.1097/00007632-200012010-00015.
- 7. Mostafa E, Varacallo M. Anatomy, Back, Coccygeal Vertebrae. 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31751060.
- 8. Patel R, Appannagari A, Whang PG. Coccydynia. Curr Rev Musculoskelet Med. 2008;1(3–4):223–6. doi: 10.1007/s12178-008-9028-1.
- 9. Garg B, Ahuja K. Coccydynia-A comprehensive review on etiology, radiological features and management options. J Clin Orthop trauma. 2021;12(1):123–9. doi: 10.1016/j.jcot.2020.09.025.
- 10. De Andrés J, Chaves S. Coccygodynia: a proposal for an algorithm for treatment. J pain. 2003;4(5):257–66. doi: 10.1016/s1526-5900(03)00620-5.
- 11. Indiran V, Sivakumar V, Maduraimuthu P. Coccygeal Morphology on Multislice Computed Tomography in a Tertiary Hospital in India. Asian Spine J. 2017;11(5):694–9. doi: 10.4184/asj.2017.11.5.694.
- 12. Kerimoglu U, Dagoglu MG, Ergen FB. Intercoccygeal angle and type of coccyx in asymptomatic patients. Surg Radiol Anat. 2007;29(8):683–7. doi: 10.1007/s00276-007-0262-9.
- 13. Hochgatterer R, Gahleitner M, Allerstorfer J, Maier J, Luger M, Großbötzl G, et al. Coccygectomy for coccygodynia: a cohort study with a long-term follow-up of up to 29 years. Eur Spine J. 2021;30:1072–6. doi: 10.1007/s00586-020-06627-w.
- 14. Gebba M. Morphometric Study of the Normal Egyptian Coccyx from (Age 1-40 Year). Int J Clin Dev Anat. 2015;1:32–41. doi: 10.11648/j.ijcda.20150102.13
- 15. Woon JTK, Maigne J-Y, Perumal V, Stringer MD. Magnetic resonance imaging morphology and morphometry of the coccyx in coccydynia. Spine (Phila Pa 1976). 2013;38(23):E1437-45. doi: 10.1097/BRS.0b013e3182a45e07.
- 16. Woon JTK, Perumal V, Maigne J-Y, Stringer MD. CT morphology and morphometry of the normal adult coccyx. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2013;22(4):863–70. doi: 10.1007/s00586-012-2595-2.
- 17. Woon JTK, Stringer MD. Clinical anatomy of the coccyx: A systematic review. Clin Anat. 2012;25(2):158–67. doi: 10.1002/ca.21216.
- 18. Przybylski P, Pankowicz M, Boćkowska A, Czekajska-Chehab E, Staśkiewicz G, Korzec M, et al. Evaluation of coccygeal bone variability, intercoccygeal and lumbo-sacral angles in asymptomatic patients in multislice computed tomography. Anat Sci Int. 2013;88(4):204–11. doi: 10.1007/s12565-013-0181-2.
- 19. Tetiker H, Koşar MI, Çullu N, Canbek U, Otağ I, Taştemur Y. MRI-based detailed evaluation of the anatomy of the human coccyx among Turkish adults. Niger J Clin Pract. 2017;20(2):136–42. doi: 10.4103/1119-3077.198313. 20. Yoon MG, Moon M-S, Park BK, Lee H, Kim D-H. Analysis of Sacrococcygeal Morphology in Koreans Using Computed Tomography. Clin Orthop Surg. 2016;8(4):412–9. doi: 10.4055/cios.2016.8.4.412.
- 21. Tague RG. Fusion of coccyx to sacrum in humans: prevalence, correlates, and effect on pelvic size, with obstetrical and evolutionary implications. Am J Phys Anthropol. 2011;145(3):426–37. doi: 10.1002/ajpa.21518.
Abstract
Amaç: Kuyruk sokumu morfolojisi değişiklik göstermektedir. Bu çeşitlilik idiyopatik koksidinideki radyolojik patolojilerin anlaşılmasını zorlaştırmaktadır. Bu çalışma, bir dizi toplumsal referans değeri oluşturmak için Türk toplumundaki kuyruk sokumu morfolojisini incelemeyi amaçlamıştır.
Yöntem: Bin yetişkinin bilgisayarli tomografi taramasının retrospektif analizi ile aşağıdakiler değerlendirilmiştir: koksigeal segment sayısı, koksiks tipi, sakrokoksigeal ve interkoksigeal eklem füzyonu, koksigeal spiküller, sakrokoksigeal düz uzunluk, sakrokoksigeal ve interkoksigeal eğrilik açıları ve kuyruk sokumu ucunun lateral sapması.
Bulgular: En sık görülen koksiks segment sayısı dört, en sık görülen koksiks tipi ise II olarak belirlenmiştir. Sakrokoksigeal füzyon %69,5, interkoksigeal füzyon ise %83,6 sıklıktadır. Olguların %3,7'sinde koksigeal spikül görülmüştür. Ortalama sakrokoksigeal düz uzunluk erkeklerde 34,3 mm, kadınlarda 32,2 mm idi; bu uzunluk da erkek grupta anlamlı olarak daha yüksekti (p<0,001). Ortalama sakrokoksigeal eğrilik açısı kadınlarda 108,8°, erkeklerde 112,7°; bu açı erkek grupta anlamlı olarak daha genişti (p<0,001).
Sonuç: Asemptomatik Türk bireylerde yapılan bu çalışma bugüne kadar yapılan en kapsamlı çalışma olup, gelecekte semptomatik olgularla yapılacak çalışmalarda kuyruk sokumu kemiğinin toplumsal morfolojisi ve koksidini etiyolojisinin belirlenmesi amacıyla “toplumsal referans değerleri seti” olarak kullanılabilir.
Keywords
Project Number
yok
References
- 1. Foye PM. Coccydynia: Tailbone Pain. Phys Med Rehabil Clin N Am. 2017;28(3):539–49. doi: 10.1016/j.pmr.2017.03.006.
- 2. Nathan ST, Fisher BE, Roberts CS. Coccydynia: a review of pathoanatomy, aetiology, treatment and outcome. J Bone Joint Surg Br. 2010;92(12):1622–7. doi: 10.1302/0301-620X.92B12.25486.
- 3. Lee J-Y, Gil Y-C, Shin K-J, Kim J-N, Joo S-H, Koh K-S, et al. An Anatomical and Morphometric Study of the Coccyx Using Three-Dimensional Reconstruction. Anat Rec (Hoboken). 2016;299(3):307–12. doi: 10.1002/ar.23300.
- 4. Maigne JY, Pigeau I, Roger B. Magnetic resonance imaging findings in the painful adult coccyx. Eur Spine J. 2012;21(10):2097-104. doi: 10.1007/s00586-012-2202-6.
- 5. Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J. 2014;14(1):84–7. PMID: 24688338
- 6. 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(23):3072–9. doi: 10.1097/00007632-200012010-00015.
- 7. Mostafa E, Varacallo M. Anatomy, Back, Coccygeal Vertebrae. 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31751060.
- 8. Patel R, Appannagari A, Whang PG. Coccydynia. Curr Rev Musculoskelet Med. 2008;1(3–4):223–6. doi: 10.1007/s12178-008-9028-1.
- 9. Garg B, Ahuja K. Coccydynia-A comprehensive review on etiology, radiological features and management options. J Clin Orthop trauma. 2021;12(1):123–9. doi: 10.1016/j.jcot.2020.09.025.
- 10. De Andrés J, Chaves S. Coccygodynia: a proposal for an algorithm for treatment. J pain. 2003;4(5):257–66. doi: 10.1016/s1526-5900(03)00620-5.
- 11. Indiran V, Sivakumar V, Maduraimuthu P. Coccygeal Morphology on Multislice Computed Tomography in a Tertiary Hospital in India. Asian Spine J. 2017;11(5):694–9. doi: 10.4184/asj.2017.11.5.694.
- 12. Kerimoglu U, Dagoglu MG, Ergen FB. Intercoccygeal angle and type of coccyx in asymptomatic patients. Surg Radiol Anat. 2007;29(8):683–7. doi: 10.1007/s00276-007-0262-9.
- 13. Hochgatterer R, Gahleitner M, Allerstorfer J, Maier J, Luger M, Großbötzl G, et al. Coccygectomy for coccygodynia: a cohort study with a long-term follow-up of up to 29 years. Eur Spine J. 2021;30:1072–6. doi: 10.1007/s00586-020-06627-w.
- 14. Gebba M. Morphometric Study of the Normal Egyptian Coccyx from (Age 1-40 Year). Int J Clin Dev Anat. 2015;1:32–41. doi: 10.11648/j.ijcda.20150102.13
- 15. Woon JTK, Maigne J-Y, Perumal V, Stringer MD. Magnetic resonance imaging morphology and morphometry of the coccyx in coccydynia. Spine (Phila Pa 1976). 2013;38(23):E1437-45. doi: 10.1097/BRS.0b013e3182a45e07.
- 16. Woon JTK, Perumal V, Maigne J-Y, Stringer MD. CT morphology and morphometry of the normal adult coccyx. Eur spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2013;22(4):863–70. doi: 10.1007/s00586-012-2595-2.
- 17. Woon JTK, Stringer MD. Clinical anatomy of the coccyx: A systematic review. Clin Anat. 2012;25(2):158–67. doi: 10.1002/ca.21216.
- 18. Przybylski P, Pankowicz M, Boćkowska A, Czekajska-Chehab E, Staśkiewicz G, Korzec M, et al. Evaluation of coccygeal bone variability, intercoccygeal and lumbo-sacral angles in asymptomatic patients in multislice computed tomography. Anat Sci Int. 2013;88(4):204–11. doi: 10.1007/s12565-013-0181-2.
- 19. Tetiker H, Koşar MI, Çullu N, Canbek U, Otağ I, Taştemur Y. MRI-based detailed evaluation of the anatomy of the human coccyx among Turkish adults. Niger J Clin Pract. 2017;20(2):136–42. doi: 10.4103/1119-3077.198313. 20. Yoon MG, Moon M-S, Park BK, Lee H, Kim D-H. Analysis of Sacrococcygeal Morphology in Koreans Using Computed Tomography. Clin Orthop Surg. 2016;8(4):412–9. doi: 10.4055/cios.2016.8.4.412.
- 21. Tague RG. Fusion of coccyx to sacrum in humans: prevalence, correlates, and effect on pelvic size, with obstetrical and evolutionary implications. Am J Phys Anthropol. 2011;145(3):426–37. doi: 10.1002/ajpa.21518.
Details
| Primary Language | English |
|---|---|
| Subjects | Brain and Nerve Surgery (Neurosurgery) |
| Journal Section | Research Article |
| Authors | |
| Project Number | yok |
| Publication Date | April 30, 2024 |
| Submission Date | March 6, 2024 |
| Acceptance Date | April 23, 2024 |
| Published in Issue | Year 2024 Volume: 8 Issue: 1 |
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