Klinik Araştırma
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Yıl 2025, Cilt: 35 Sayı: 1, 97 - 103, 28.02.2025
https://doi.org/10.54005/geneltip.1533407

Öz

Kaynakça

  • 1. Maigne JY, Guedj S, Straus C. Idiopathic coccygodynia lateral roentgenograms in the sitting position and coccygeal discography. Spine J. 1994;19(8):930-4.
  • 2. Howard PD, Dolan AN, Falco AN, Holland BM, Wilkinson CF, Zink AM. A comparison of conservative interventions and their effectiveness for coccydynia: a systematic review. Man Ther. 2013;21(4):213-9.
  • 3. Oh CS, Chung IH, Ji HJ, Yoon DM. Clinical implications of topographic anatomy on the ganglion impar. Anesthesiology. 2004;101(1):249-50.
  • 4. Adams F. The seven books of Paulus Aegineta. C. 1. Sydenham Society; 1844.
  • 5. Maigne JY, Doursounian L, Chatellier G. Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine J. 2000;25(23):3072-9.
  • 6. Schapiro S. Low back and rectal pain from an orthopedic and proctologic viewpoint with a review of 180 cases. Am J Surg. 1950;79(1):117-28.
  • 7. Pennekamp PH, Kraft CN, Stütz A, Wallny T, Schmitt O, Diedrich O. Coccygectomy for coccygodynia: does pathogenesis matter? J Trauma Acute Care Surg. 2005;59(6):1414-9.
  • 8. Postacchini F, Massobrio M. Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. JBJS. 1983;65(8):1116-24.
  • 9. Maroy B. Spontaneous and evoked coccygeal pain in depression. Diseases of the colon & rectum. 1988;31:210-5.
  • 10. Trollegaard A, Aarby N, Hellberg S. Coccygectomy: an effective treatment option for chronic coccydynia: retrospective results in 41 consecutive patients. J Bone Joint Surg Br. 2010;92(2):242-5.
  • 11. Kırcelli A, Demirçay E, Özel Ö, Çöven I, Işık S, Civelek E, vd. Radiofrequency Thermocoagulation of the Ganglion Impar for Coccydynia Management: Long‐Term Effects. Pain Pract. 2019;19(1):9-15.
  • 12. Mitra R, Cheung L, Perry P. Efficacy of fluoroscopically guided steroid injections in the management of coccydynia. Pain Physician. 2007;10(6):775.
  • 13. Seker A, Sarikaya IA, Korkmaz O, Yalcin S, Malkoc M, Bulbul AM. Management of persistent coccydynia with transrectal manipulation: results of a combined procedure. Eur Spine J. 2018;27:1166-71.
  • 14. Plancarte R. Presacral blockade of the ganglion of Walther (ganglion impar). Anesthesiology. 1990;73:751.
  • 15. Kim ST, Ryu SJ. Treatment of Hyperhidrosis Occurring during Hemodialysis: Ganglion Impar Block: A case report. Korean J Anesthesiol. 2005;48(5):553-6.
  • 16. Scott-Warren JT, Hill V, Rajasekaran A. Ganglion impar blockade: a review. Curr Pain Headache Rep. 2013;17:1-6.
  • 17. Gupta D, Jain R, Mishra S, Kumar S, Thulkar S, Bhatnagar S. Ultrasonography Reinvents the Originally Described Technique for Ganglion Impar Neurolysis in Perianal Cancer Pain: Retracted. Anesth Analg. 2008;107(4):1390-2.
  • 18. Datir A, Connell D. CT-guided injection for ganglion impar blockade: a radiological approach to the management of coccydynia. Clin Radiol. 2010;65(1):21-5.
  • 19. Wemm Jr K, Saberski L. Modified approach to block the ganglion impar (ganglion of Watther). Reg Anesth Pain Med. 1995;20(6):544-5.
  • 20. Foye PM, Buttaci CJ, Stitik TP, Yonclas PP. Successful injection for coccyx pain. Am J Phys Med Rehabil. 2006;85(9):783-4.
  • 21. Reig E, Abejón D, Del Pozo C, Insausti J, Contreras R. Thermocoagulation of the ganglion impar or ganglion of Walther: description of a modified approach. Preliminary results in chronic, nononcological pain. Pain Pract. 2005;5(2):103-10.
  • 22. Kersey P. Non-operative management of coccygodynia. The Lancet. 1980;315(8163):318.
  • 23. Grosso NP, van Dam BE. Total coccygectomy for the relief of coccygodynia: a retrospective review. Clin Spine Surg. 1995;8(4):328-30.
  • 24. Gunduz OH, Sencan S, Kenis-Coskun O. Pain relief due to transsacrococcygeal ganglion impar block in chronic coccygodynia: a pilot study. Pain Med. 2015;16(7):1278-81.
  • 25. 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.
  • 26. Gonnade N, Mehta N, Khera PS, Kumar D, Rajagopal R, Sharma PK. Ganglion impar block in patients with chronic coccydynia. Indian J Radiol Imaging. 2017;27(03):324-8.
  • 27. Fogel GR, Cunningham III PY, Esses SI. Coccygodynia: evaluation and management. J Am Acad Orthop Surg. 2004;12(1):49-54.
  • 28. Maigne JY, Chatellier G, Le Faou M, Archambeau M. The treatment of chronic coccydynia with intrarectal manipulation: a randomized controlled study. Spine J. 2006;
  • 29. Sencan S, Kenis-Coskun O, Demir FGU, Cuce I, Ercalık T, Gunduz OH. Ganglion Impar block improves neuropathic pain in coccygodynia: A preliminary report. Neurol Neurochır Pol. 2018;52(5):612-7.
  • 30. Sencan S, Edipoglu IS, Demir FGU, Yolcu G, Gunduz OH. Are steroids required in the treatment of ganglion impar blockade in chronic coccydynia? A prospective double-blinded clinical trial. Korean J Pain. 2019;32(4):301-6.
  • 31. Schilling LS, Markman JD. Corticosteroids for pain of spinal origin: epidural and intraarticular administration. Rheum Dis Clin. 2016;42(1):137-55.
  • 32. Buttaci CJ, Foye PM, Stitik TP. Coccydynia successfully treated with ganglion impar blocks: a case series. Am J Phys Med. 2005;84(3):218.
  • 33. SAĞIR Ö, Özaslan S, Köroğlu A. Koksiks dislokasyonlu hastada impar ganglion bloğu uygulaması. Ağrı. 2011;23(3):129-33.
  • 34. Loev MA, Varklet VL, Wilsey BL, Ferrante MF. Cryoablation: a novel approach to neurolysis of the ganglion impar. Anesthesiology. 1998;88(5):1391-3.
  • 35. Gupta N, Garg R, Saini S, Bharti SJ, Kumar V. An unusual complication after ganglion impar block for chronic cancer pain management. AANA J. 2017;85(6):424-6.

Early clinical results of intracoxygeal impar ganglion block for patients with persistent posttraumatic coccydynia

Yıl 2025, Cilt: 35 Sayı: 1, 97 - 103, 28.02.2025
https://doi.org/10.54005/geneltip.1533407

Öz

Background/Aims: Coxadini is a painful disease of the vertebral apex whose most common aetiological cause is direct-indirect trauma. While in acute cases cure is usually achieved with conservative treatment, in persistent cases interventional treatment methods come to the fore. Injections are often used when there is no response to conservative treatment. Injections can be given either directly into the posterior coccygeal region under fluoroscopic guidance or into the precoccygeal region. The most commonly favoured precoccygeal block is the impar ganglion block. In our study, we aimed to analyse the pain and sleep quality of patients who had undergone ganglion impar blockade at the end of the one-year follow-up.
Material and Methods: Patients who presented with coxadinia between October 2019 and April 2021 were retrospectively analysed. Patients who did not respond to conservative treatment, were over 18 years of age at the time of the procedure, had symptoms that persisted for more than 6 months and agreed to participate in the study were included in the study. The VAS, SF-36 and Pittsburg Sleep Quality Index measurements recorded at the first examination of the patients were analysed. All patients were called in for a final follow-up 12 months after the injection and the VAS, SF-36 and Pittsburg Sleep Quality Index assessments were repeated.
Results: 20 patients (17F / 3M) were included in our study. The mean age of my patients at the time of intervention was 41.05 ± 11.27. The mean time from symptom onset to intervention was 22.25 ± 17.06 weeks. There was a significant decrease in VAS scores, and significant improvement in SF-36 subcategories and Pittsburgh Sleep Quality Index scores. (p < 0.001)
Conclusion: Ganglion impar injection is a treatment method that can help relieve pain, improve sleep quality and daily-life functions in cases that do not respond to medical treatment and lifestyle changes

Kaynakça

  • 1. Maigne JY, Guedj S, Straus C. Idiopathic coccygodynia lateral roentgenograms in the sitting position and coccygeal discography. Spine J. 1994;19(8):930-4.
  • 2. Howard PD, Dolan AN, Falco AN, Holland BM, Wilkinson CF, Zink AM. A comparison of conservative interventions and their effectiveness for coccydynia: a systematic review. Man Ther. 2013;21(4):213-9.
  • 3. Oh CS, Chung IH, Ji HJ, Yoon DM. Clinical implications of topographic anatomy on the ganglion impar. Anesthesiology. 2004;101(1):249-50.
  • 4. Adams F. The seven books of Paulus Aegineta. C. 1. Sydenham Society; 1844.
  • 5. Maigne JY, Doursounian L, Chatellier G. Causes and mechanisms of common coccydynia: role of body mass index and coccygeal trauma. Spine J. 2000;25(23):3072-9.
  • 6. Schapiro S. Low back and rectal pain from an orthopedic and proctologic viewpoint with a review of 180 cases. Am J Surg. 1950;79(1):117-28.
  • 7. Pennekamp PH, Kraft CN, Stütz A, Wallny T, Schmitt O, Diedrich O. Coccygectomy for coccygodynia: does pathogenesis matter? J Trauma Acute Care Surg. 2005;59(6):1414-9.
  • 8. Postacchini F, Massobrio M. Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. JBJS. 1983;65(8):1116-24.
  • 9. Maroy B. Spontaneous and evoked coccygeal pain in depression. Diseases of the colon & rectum. 1988;31:210-5.
  • 10. Trollegaard A, Aarby N, Hellberg S. Coccygectomy: an effective treatment option for chronic coccydynia: retrospective results in 41 consecutive patients. J Bone Joint Surg Br. 2010;92(2):242-5.
  • 11. Kırcelli A, Demirçay E, Özel Ö, Çöven I, Işık S, Civelek E, vd. Radiofrequency Thermocoagulation of the Ganglion Impar for Coccydynia Management: Long‐Term Effects. Pain Pract. 2019;19(1):9-15.
  • 12. Mitra R, Cheung L, Perry P. Efficacy of fluoroscopically guided steroid injections in the management of coccydynia. Pain Physician. 2007;10(6):775.
  • 13. Seker A, Sarikaya IA, Korkmaz O, Yalcin S, Malkoc M, Bulbul AM. Management of persistent coccydynia with transrectal manipulation: results of a combined procedure. Eur Spine J. 2018;27:1166-71.
  • 14. Plancarte R. Presacral blockade of the ganglion of Walther (ganglion impar). Anesthesiology. 1990;73:751.
  • 15. Kim ST, Ryu SJ. Treatment of Hyperhidrosis Occurring during Hemodialysis: Ganglion Impar Block: A case report. Korean J Anesthesiol. 2005;48(5):553-6.
  • 16. Scott-Warren JT, Hill V, Rajasekaran A. Ganglion impar blockade: a review. Curr Pain Headache Rep. 2013;17:1-6.
  • 17. Gupta D, Jain R, Mishra S, Kumar S, Thulkar S, Bhatnagar S. Ultrasonography Reinvents the Originally Described Technique for Ganglion Impar Neurolysis in Perianal Cancer Pain: Retracted. Anesth Analg. 2008;107(4):1390-2.
  • 18. Datir A, Connell D. CT-guided injection for ganglion impar blockade: a radiological approach to the management of coccydynia. Clin Radiol. 2010;65(1):21-5.
  • 19. Wemm Jr K, Saberski L. Modified approach to block the ganglion impar (ganglion of Watther). Reg Anesth Pain Med. 1995;20(6):544-5.
  • 20. Foye PM, Buttaci CJ, Stitik TP, Yonclas PP. Successful injection for coccyx pain. Am J Phys Med Rehabil. 2006;85(9):783-4.
  • 21. Reig E, Abejón D, Del Pozo C, Insausti J, Contreras R. Thermocoagulation of the ganglion impar or ganglion of Walther: description of a modified approach. Preliminary results in chronic, nononcological pain. Pain Pract. 2005;5(2):103-10.
  • 22. Kersey P. Non-operative management of coccygodynia. The Lancet. 1980;315(8163):318.
  • 23. Grosso NP, van Dam BE. Total coccygectomy for the relief of coccygodynia: a retrospective review. Clin Spine Surg. 1995;8(4):328-30.
  • 24. Gunduz OH, Sencan S, Kenis-Coskun O. Pain relief due to transsacrococcygeal ganglion impar block in chronic coccygodynia: a pilot study. Pain Med. 2015;16(7):1278-81.
  • 25. 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.
  • 26. Gonnade N, Mehta N, Khera PS, Kumar D, Rajagopal R, Sharma PK. Ganglion impar block in patients with chronic coccydynia. Indian J Radiol Imaging. 2017;27(03):324-8.
  • 27. Fogel GR, Cunningham III PY, Esses SI. Coccygodynia: evaluation and management. J Am Acad Orthop Surg. 2004;12(1):49-54.
  • 28. Maigne JY, Chatellier G, Le Faou M, Archambeau M. The treatment of chronic coccydynia with intrarectal manipulation: a randomized controlled study. Spine J. 2006;
  • 29. Sencan S, Kenis-Coskun O, Demir FGU, Cuce I, Ercalık T, Gunduz OH. Ganglion Impar block improves neuropathic pain in coccygodynia: A preliminary report. Neurol Neurochır Pol. 2018;52(5):612-7.
  • 30. Sencan S, Edipoglu IS, Demir FGU, Yolcu G, Gunduz OH. Are steroids required in the treatment of ganglion impar blockade in chronic coccydynia? A prospective double-blinded clinical trial. Korean J Pain. 2019;32(4):301-6.
  • 31. Schilling LS, Markman JD. Corticosteroids for pain of spinal origin: epidural and intraarticular administration. Rheum Dis Clin. 2016;42(1):137-55.
  • 32. Buttaci CJ, Foye PM, Stitik TP. Coccydynia successfully treated with ganglion impar blocks: a case series. Am J Phys Med. 2005;84(3):218.
  • 33. SAĞIR Ö, Özaslan S, Köroğlu A. Koksiks dislokasyonlu hastada impar ganglion bloğu uygulaması. Ağrı. 2011;23(3):129-33.
  • 34. Loev MA, Varklet VL, Wilsey BL, Ferrante MF. Cryoablation: a novel approach to neurolysis of the ganglion impar. Anesthesiology. 1998;88(5):1391-3.
  • 35. Gupta N, Garg R, Saini S, Bharti SJ, Kumar V. An unusual complication after ganglion impar block for chronic cancer pain management. AANA J. 2017;85(6):424-6.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ortopedi
Bölüm Original Article
Yazarlar

Mete Gedikbaş 0000-0003-3782-5535

Utkan Sobay 0000-0002-4640-8955

Mehmet Burtaç Eren 0000-0002-5888-8677

Yayımlanma Tarihi 28 Şubat 2025
Gönderilme Tarihi 14 Ağustos 2024
Kabul Tarihi 22 Ocak 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 35 Sayı: 1

Kaynak Göster

Vancouver Gedikbaş M, Sobay U, Eren MB. Early clinical results of intracoxygeal impar ganglion block for patients with persistent posttraumatic coccydynia. Genel Tıp Derg. 2025;35(1):97-103.