Research Article
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Evaluation of Lumbo-Sacro-Coccygeal Angels and Coccyx Anatomy in Pilonidal Disease Etiology.

Year 2020, Volume: 27 Issue: 2, 174 - 178, 01.06.2020
https://doi.org/10.17343/sdutfd.480363

Abstract

Aim: Several risk factors were
defined in the etiology of pilonidal sinus, including obesity, sitting habbits,
and deep intergluteal sulcus. The aim of our study was to evaluate the
lumbo-sacro-coccigeal region angulation and coccyx anatomy in terms of
pilonidal sinus.

Methods: The patients who applied with
pilonidal sinus that performed coccyx graphies and healty individuals who
applied for routine health control that performed lateral lumbosacral were
included in the study. Age, gender, coccyx type and pathologies, lumbosacral,
sacrococcygeal, intercoccygeal and sacrococcygeal sinus angles were evaluated
retrospectively.

Results: A total of 160 patients (66
pilonidal sinus and 94 controls) were included in the study. All patients were
male and the mean age was 23.87 ± 2.47 years. Type II coccyx was observed the
most common in both groups (45.5% and 85.1%, respectively), Type I (27.3%) was
seen only in the pilonidal sinus. Type III (21.2%) was the most frequent in the
Pilonidal sinus, but Type IV (11.7%) was the most frequent in the control
group. There were no statistically significant difference between the groups.
In the pilonidal sinus, the rate of coccyx pathology was 27.3% and 19.1% in the
control group, but there is no statistically significant difference. The
difference between the angles of lumbosacral and sacrococcygeal were
statistically significant (p = 0.0001, p = 0.001, respectively), but the
difference between angels of intercoccygeal and sacrococcygeal sinus were not
statistically significant (p> 0.05).







Conclusion: Especially Type I, partially Type
III, coccyx pathologies, lumbosacral and sacrococcygeal angles are the important
risk factors in the etiology of pilonidal sinus, together with other risk
factors that defined.

References

  • 1. de Parades V, Bouchard D, Janier M, Berger A. Pilonidal sinus disease. J Visc Surg. 2013 Sep;150(4):237-47. doi: 10.1016/j.jviscsurg.2013.05.006.
  • 2. von Laffert M, Stadie V, Ulrich J, Marsch W, C, Wohlrab J: Morphology of Pilonidal Sinus Disease: Some Evidence of Its Being a Unilocalized Type of Hidradenitis Suppurativa. Dermatology 2011;223:349-355. doi: 10.1159/000335373
  • 3. Harlak A, Mentes O, Kilic S, Coskun K, Duman K, Yilmaz F. Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors. Clinics 2010;65(2):125–13. doi: 10.1590/S1807-59322010000200002.
  • 4. Classic articles in colonic and rectal surgery. Louis A. Buie, M.D. 1890-1975: Jeep disease (pilonidal disease of mechanized warfare). Dis Colon Rectum. 1982;25:384-90.
  • 5. Woon JT, Stringer MD. Clinical anatomy of the coccyx: A systematic review. Clin Anat. 2012 Mar;25(2):158-67. doi: 10.1002/ca.21216.
  • 6. Kerimoglu U, Dagoglu MG, Ergen FB. Intercoccygeal angle and type of coccyx in asymptomatic patients. Surg Radiol Anat. 2007 Dec;29(8):683-7. doi: 10.1007/s00276-007-0262-9
  • 7. 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 Sep;88(4):204-11. doi: 10.1007/s12565-013-0181-2.
  • 8. Kaplan M, Ozturk S, Cakin H, Akgun B, Onur MR, Erol FS. Sacrococcygeal sinus angle: as a new anatomic landmark for the posterior approach of presacrallesions. Eur Spine J. 2014 Feb;23(2):337-40. doi: 10.1007/s00586-013-2830-5.
  • 9. Eryilmaz R, Isik A, Okan I, Bilecik T, Yekeler E, Sahin M. Does Sacrococcygeal Angle Play a Role on Pilonidal Sinus Etiology? Prague Med Rep. 2015;116(3):219-24. doi: 10.14712/23362936.2015.61.
  • 10. Postacchini F, Massobrio M. Idiopathic coccygodynia. Analysis of Wfty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg Am 1983;65:1116–1124
  • 11. Maigne JY, Doursounian L, Chatellier G. Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine 2000;25:3072-9.

Pilonidal Sinüs Etyolojisinde Lumbo-Sakro-Koksigeal Açıların ve Koksiks Anatomisinin Değerlendirilmesi.

Year 2020, Volume: 27 Issue: 2, 174 - 178, 01.06.2020
https://doi.org/10.17343/sdutfd.480363

Abstract

Amaç: Pilonidal sinüs etyolojisinde
obezite, oturarak çalışma, derin intergluteal sulkus başta olmak üzere birçok
risk faktörü tanımlanmıştır. Çalışmamızın amacı Lumbo-sakro-koksigeal bölge
açılanmalarının ve koksiks anatomisinin pilonidal sinüs açısından
değerlendirilmesidir.



Gereç ve Yöntem: Pilonidal sinüs nedeni ile
başvuran ve koksiks grafisi çekilen hastalar ile herhangi bir şikâyeti olmayan
heyet muayenesine başvuran hastaların lateral lumbosakral grafilerinde koksiks
görülen hastalar çalışmaya dâhil edildi. Hastaların yaş, cinsiyet, koksiks tip
ve patolojileri, lumbosakral, sakrokoksigeal, interkoksigeal ve sakrokoksigeal
sinüs açıları geriye dönük değerlendirildi.



Bulgular: 66 pilonidal sinüs, 94 kontrol
olmak üzere toplam 160 hasta çalışmaya dâhil edildi. Tüm hastalar erkekti ve
yaş ortalaması 23,87± 2.47 yıldı. Her iki grupta en sık Tip II koksiks gözlendi
(sırasıyla %45,5 ve %85,1), Tip I (%27,3) sadece Pilonidal sinüste görülürken, Tip III (%21,2
) ensık Pilonidal sinüste, Tip IV (%11,7) en sık kontrol grubunda gözlendi.
Koksiks tiplerinde her iki grup arasında istatistiksel fark saptanmadı.
Pilonidal sinüste koksiks patoloji %27,3
görülürken, kontrol grubunda %19,1 görüldü, fakat istatistiksel olarak anlamlı
fark saptanmadı. Açılardan ise lumbosakral ve sakrokoksigeal açılar arasındaki
fark istatistiksel olarak anlamlı saptanırken (sırasıyla, p=0,0001, p=0,001),
interkoksigeal ve sakrokoksigeal sinüs açısı açılar arasındaki fark
istatistiksel olarak anlamlı saptanmadı (p>0,05).



Sonuç: Pilonidal sinüs etyolojisinde
diğer risk faktörleri ile birlikte, özellikle Tip I, kısmen Tip III, koksiks
patolojileri, lumbosakral ve sakrokoksigeal açıların önemli risk faktörü
olduğunu değerlendirmekteyiz.

References

  • 1. de Parades V, Bouchard D, Janier M, Berger A. Pilonidal sinus disease. J Visc Surg. 2013 Sep;150(4):237-47. doi: 10.1016/j.jviscsurg.2013.05.006.
  • 2. von Laffert M, Stadie V, Ulrich J, Marsch W, C, Wohlrab J: Morphology of Pilonidal Sinus Disease: Some Evidence of Its Being a Unilocalized Type of Hidradenitis Suppurativa. Dermatology 2011;223:349-355. doi: 10.1159/000335373
  • 3. Harlak A, Mentes O, Kilic S, Coskun K, Duman K, Yilmaz F. Sacrococcygeal pilonidal disease: analysis of previously proposed risk factors. Clinics 2010;65(2):125–13. doi: 10.1590/S1807-59322010000200002.
  • 4. Classic articles in colonic and rectal surgery. Louis A. Buie, M.D. 1890-1975: Jeep disease (pilonidal disease of mechanized warfare). Dis Colon Rectum. 1982;25:384-90.
  • 5. Woon JT, Stringer MD. Clinical anatomy of the coccyx: A systematic review. Clin Anat. 2012 Mar;25(2):158-67. doi: 10.1002/ca.21216.
  • 6. Kerimoglu U, Dagoglu MG, Ergen FB. Intercoccygeal angle and type of coccyx in asymptomatic patients. Surg Radiol Anat. 2007 Dec;29(8):683-7. doi: 10.1007/s00276-007-0262-9
  • 7. 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 Sep;88(4):204-11. doi: 10.1007/s12565-013-0181-2.
  • 8. Kaplan M, Ozturk S, Cakin H, Akgun B, Onur MR, Erol FS. Sacrococcygeal sinus angle: as a new anatomic landmark for the posterior approach of presacrallesions. Eur Spine J. 2014 Feb;23(2):337-40. doi: 10.1007/s00586-013-2830-5.
  • 9. Eryilmaz R, Isik A, Okan I, Bilecik T, Yekeler E, Sahin M. Does Sacrococcygeal Angle Play a Role on Pilonidal Sinus Etiology? Prague Med Rep. 2015;116(3):219-24. doi: 10.14712/23362936.2015.61.
  • 10. Postacchini F, Massobrio M. Idiopathic coccygodynia. Analysis of Wfty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg Am 1983;65:1116–1124
  • 11. Maigne JY, Doursounian L, Chatellier G. Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine 2000;25:3072-9.
There are 11 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Dursun Özgür Karakaş

İbrahim Yılmaz

Bülent Karslıoğlu

Aykut Aytekin This is me

Publication Date June 1, 2020
Submission Date November 8, 2018
Acceptance Date November 26, 2018
Published in Issue Year 2020 Volume: 27 Issue: 2

Cite

Vancouver Karakaş DÖ, Yılmaz İ, Karslıoğlu B, Aytekin A. Pilonidal Sinüs Etyolojisinde Lumbo-Sakro-Koksigeal Açıların ve Koksiks Anatomisinin Değerlendirilmesi. Med J SDU. 2020;27(2):174-8.

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