1251 Advances in Coccygectomy: Evaluating Surgical Techniques for Coccygodynia

INTRODUCTION: Coccygectomy has emerged as a crucial technique for treating refractory coccygodynia, but there is heterogeneity in the literature regarding indications for various methods as traditional techniques give way to novel approaches. METHODS: A thorough review was conducted of the literature on surgical techniques for coccygectomy in the treatment of coccygodynia. Traditional approaches like midline and paramedian coccygectomy were compared, the use of partial versus complete resections was evaluated, and innovative techniques such as minimally invasive endoscopic methods were described. Trade-offs between complication rates and functional outcomes with different techniques were assessed. RESULTS: Midline and paramedian approaches offer direct access but have wound complication risks. Partial resection is less invasive but has higher symptom recurrence, while complete resection eliminates pain but has greater blood loss and recovery time. Innovative techniques like coccygeoplasty and endoscopic approaches are minimally invasive with faster recovery. Individualized treatment planning is key given the various trade-offs between complication rates and outcomes observed with different techniques CONCLUSIONS: A range of surgical techniques exist for coccygectomy, each with advantages and disadvantages. Promising new minimally invasive and endoscopic techniques are emerging. Technique selection should be individualized based on patient factors. With ongoing innovation, the potential exists for further improving coccygodynia treatment outcomes in the future.