A dynamic alphanumeric classification system for non-traumatic coccydynia: Further defining clinical and research...

Area of Science:

• Orthopedics and Sports Medicine
• Radiology
• Biomechanics

Background:

• Increasing sedentary lifestyles contribute to non-traumatic coccydynia, a poorly understood condition.
• Current classification systems are inadequate for diagnosing and treating coccydynia.
• Sedentary behavior and prolonged sitting are identified risk factors for coccydynia.

Purpose of the Study:

• To analyze coccygeal morphology in the Indian population.
• To compare dynamic sacrococcygeal radiological indices between coccydynia patients and controls.
• To evaluate relevant sacropelvic radiological parameters.

Main Methods:

• A case-control study involving 69 participants (33 cases, 36 controls) was conducted.
• Dynamic lateral view radiographs of the lumbosacral spine and coccyx were analyzed.
• Measurements included coccyx type, subluxation, mobility, and sacrococcygeal/pelvic parameters, using a novel dynamic alphanumeric classification.

Main Results:

• Type IV coccyx and above were more prevalent in coccydynia cases compared to controls (Type I more common in controls).
• Posterior subluxations at the sacrococcygeal/intercoccygeal joint were significantly associated with coccydynia.
• A change of 2 or more grades in coccyx type on dynamic radiographs was exclusive to the non-traumatic coccydynia group.

Conclusions:

• Non-traumatic coccydynia is a dynamic condition requiring assessment via dynamic radiography.
• Specific coccyx types (III and higher), significant dynamic changes (≥2 grades), and posterior subluxations are linked to coccydynia.
• Sacropelvic parameters were not found to be significant causative factors in this study.