Magnetic resonance imaging evaluation of coccyx morphology and morphometry in childhood

Yıl 2023, Cilt: 17 Sayı: 2, 55 - 61, 31.08.2023

Muhsin Özgün Öztürk , Berna Uçan Kemal Buğra Memiş , Sonay Aydın

Öz

Objectives: Pain around the coccyx is referred to as coccydynia. Inter coccygeal and sacrococcygeal angles as well as some types of coccyx may be associated with idiopathic coccydynia. The aim of this retrospective study was to evaluate the morphology and morphometry of the coccyx using MRI and to determine whether morphologic-morphometric features are associated with coccydynia in the pediatric population.
Methods: This study was performed retrospectively on children aged 10–17 years who underwent pelvic and sacral magnetic resonance imaging for non-trauma related reasons. Inter coccygeal-sacrococcygeal angles and coccyx types were determined using sagittal T1- and T2-weighted images. Gender-specific assessments were made for intercoccigeal and sacrococcygeal angles as well as coccyx types based on Postacchinni and Massobrio classification. In statistical analysis, a p-value less than 0.05 was considered statistically significant.
Results: One hundred and fifty-six children were included in the final analysis (108 girls, 48 boys). The mean age of the cases was 13.8 years (10–17). Type 1 was the most common type overall, accounting for 57.7% of the population. The sacrococcygeal angles of boys were significantly higher than those of girls. A significant negative correlation was found between age and sacrococcygeal angle. In children with Type 1 and Type 2 coccyx, girls had significantly higher intercoccigeal angles than boys. The intercoccigeal angle varied significantly in each coccyx type and the intercoccigeal angles increased significantly as the coccyx type increased (from Type 1 to Type 4). The most common coccyx type in the coccidynia group was Type 2, while the most common type in the control group was Type 1. The mean intercoccigeal angles of children with coccidynia were significantly higher than those of the control group.
Conclusion: Coccydynia is a symptom with many possible reasons rather than a diagnosis. Coccyx morphology and morphometry can be associated with idiopathic coccydynia. To better understand these morphological and morphometric features, especially in the pediatric population, larger population studies are required.

Anahtar Kelimeler

coccyx, intercoccygeal angle, MRI, sacrococcygeal angle

Kaynakça

• Tetiker H, Koşar Mİ, Çullu N, Canbek U, Otağ İ, Taştemur Y. MRI-based detailed evaluation of the anatomy of the human coccyx among Turkish adults. Niger J Clin Pract 20:136–42.
• Garg B, Ahuja K. Coccydynia-a comprehensive review on etiology, radiological features and management options. J Clin Orthop Trauma 2021;12:123–9.
• Balain B, Eisenstein SM, Alo GO. Coccygectomy for coccydynia: case series and review of literature. Spine (Phila Pa 1976) 2006;31:E414–20.
• Shams A, Gamal O, Mesregah MK. Sacrococcygeal morphologic and morphometric risk factors for idiopathic coccydynia: a magnetic resonance imaging study. Global Spine J 2023;13:140–8.
• Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner J 2014;14:84–7.
• Yoon MG, Moon MS, Park BK, Lee H, Kim DH. Analysis of sacrococcygeal morphology in Koreans using computed tomography. Clin Orthop Surg 2016;8:412–9.
• Karadimas EJ, Trypsiannis G, Giannoudis PV. Surgical treatment of coccygodynia: an analytic review of the literature. Eur Spine J 2011;20:698–705.
• Postacchini F, Massobrio M. Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg Am 1983;65:1116–24.
• Woon JTK, Maigne J-Y, Perumal V, Stringer MD. Magnetic resonance imaging morphology and morphometry of the coccyx in coccydynia. Spine (Phila Pa 1976) 2013;38:E1437–45.
• Kerimoglu U, Dagoglu MG, Ergen FB. Intercoccygeal angle and type of coccyx in asymptomatic patients. Surg Radiol Anat 2007;29:683–7.
• Kim NH, Suk KS. Clinical and radiological differences between traumatic and idiopathic coccygodynia. Yonsei Med J 1999;40:215–20.
• Gupta V, Agarwal N, Baruah BP. Magnetic resonance measurements of sacrococcygeal and intercoccygeal angles in normal participants and those with idiopathic coccydynia. Indian J Orthop 2018; 52:353–7.
• Geneci F, Denk CC, Uzuner MB, Ocak M, Dogan I, Sayaci EY, Gurses IA, Cay N, Baykal D, Celi̇k HH, Comert A. Morphometric evaluation of coccyx with microcomputed tomography (micro CT) and computed tomography (CT) technology. Tıpta Yenilikçi Yaklaşımlar Dergisi 2022;3:1–19.
• Woon JTK, Perumal V, Maigne JY, Stringer MD. CT morphology and morphometry of the normal adult coccyx Eur Spine J 2013;22:863–70.
• Marwan YA, Al-Saeed OM, Bendary AM, Elsayed M, Azeem A. Computed tomography-based morphologic and morphometric features of the coccyx among Arab adults. Spine (Phila Pa 1976) 2014;39:1210–9.