Coccyx fractures in patients with spinal cord injury

The aim of this study was to report whether coccyx fractures are present in spinal cord injury (SCI) patients, who suffered from painful symptoms in the low back, gluteal, hip and thigh regions; and to determine the pain characteristics of coccydynia in these patients.

Twenty males and six females with traumatic SCI (mean age: 31.57+/-12.23 years) who described painful symptoms in the low back, hip, gluteal or thigh regions were included in the study. Pain assessment was done by using visual analogue scale (VAS) and the short form of McGill pain questionnaire. Radiological assessment comprised two-sided lumbar vertebrae, hip and coccyx X-ray graphics.

Mean duration of SCI was 19.54+/-30.08 months. Nine patients (34.62%) had coccyx fractures. Sensory Pain Index and total McGill scores were found to be significantly higher in patients with coccyx fractures. Correlation analyses revealed significant correlations between VAS, SPI, affective pain index, present pain intensity and McGill total scores (all P<0.05). Duration of SCI was correlated with SPI (P=0.03) and total McGill scores (P=0.05).

Coccyx fractures have been detected in patients with SCI and the presence of such fractures seems to affect the pain scenario unfavorably. Involved patients will be treated promptly and their rehabilitation process will be enhanced when these fractures are recognized early.