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Coccygodynia is a pathological condition associated with pain-discomfort all around the bottom end of the spine. The aetiology and the intensity of the symptoms may defer significantly. The effectiveness of the surgical treatment remains obscure. Our purpose, through this systematic review is to evaluate the results of surgical treatment of coccygectomy. Literature retrieval was performed by the use of the PubMed searching engine utilising the terms 'coccygodynia-coccygectomy' in the English language from January 1980 to January 2010. Case reports and tumour related case series were excluded as well as articles published in other languages. In total 24 manuscripts were analyzed. Only 2 of them were prospective studies whereas 22 were retrospective case series; five were classified as Level III studies and the remaining as Level IV studies. In total, 671 patients with coccygodynia underwent coccygectomy following failed conservative management. The sex ratio, male/female was 1:4.4. The most popular aetiology for coccygodynia was direct trauma in 270 patients. 504 of the patients reported an excellent/good outcome following the procedure. There were 9 deep and 47 superficial infections. Other complications included two haematomas, six delayed wound healings and nine wound dehiscence. The overall complication rate was 11%. Patients with history of spinal or rectal disorders, as well as idiopathic or with compensation issues, had less predictable outcome than those with history of trauma or childbirth. Coccygectomy can provide pain relief to as high as 85% of the cases. The most common reported complication was wound infection.

Introduction: Back pain is associated with a degree of alteration in the alignment and movement of the lumbar spine. The purpose of this study is to investigate how the degree of lumbar segmental degeneration affects sagittal changes in the lumbar spine as it shifts from the supine to the sitting (load-bearing) posture., Materials and Methods: Thirty patients with chronic low back pain were enrolled (14 male and 16 female patients); mean age 44.5 years. Their lumbar spines were initially investigated by conventional supine magnetic resonance imaging (MRI) followed later by positional MRI in the seated posture. Of the 150 discs studied, 87 were classified as healthy grade 1, 16 as grade 2, 34 as grade 3, and 13 as grade 4., Results: As the lumbar spine was loaded from the supine to the sitting position, the end-plate angles were decreased significantly as the degeneration was increased. There were also significant changes in the anterior and middle disc heights between the supine and the sitting postures irrespective of the degree of degeneration. The overall lumbar lordosis did not significantly change between the two postures., Conclusions: We have found that the changes in the segmental motion were related to the degree of degeneration. With positional MRI, we were able to demonstrate changes in healthy and degenerative discs in the weight-bearing position. More similar studies are needed to understand the complex kinematics of the lumbar spine.