Coccygectomy

What you should know

Coccygectomy is surgery to remove an unstable, dislocated, or broken coccyx after an injury. The coccyx is the small, triangular, tail-like bone near your anus, made up of 3 to 5 smaller bones. It has 2 to 3 parts joined together to form the end of your spine. A direct blow to the area near your anus may damage or break the coccyx. This may occur during a physical fight, or in contact sports. A coccyx injury may also happen during accidents, such as in a bad fall or car accident. The coccyx may break as a woman delivers a baby. In some cases, you may have coccyx pain but not know the reason why. Some or all of your coccyx bones may need to be removed. Coccygectomy is usually done to relieve symptoms, such as pain and tenderness, after all other treatments have failed.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• You may have an allergic reaction to the anesthesia medicine. You could have trouble breathing, bleed more than expected, or get an infection. An infection may lead to your wound not healing as it should, and you may need to have surgery done again. Nerves, blood vessels, ligaments, muscles, and bones may be damaged during surgery. After surgery you may have tingling or lose feeling in the area where surgery was done. After surgery you may still have pain or have trouble going back to your usual activities, including sports.
  
  
• Surgery increases your risk of getting a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening. If you do not have a coccygectomy, the pain and problems you have may get worse. Call your caregiver if you are worried or have questions about your surgery, medicine or care.

Getting Ready

The week before your surgery:

• Ask a family member or friend to drive you home after your surgery. Do not drive yourself home.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Your caregiver may give you antibiotic medicine to take before surgery. This medicine will help prevent infection.
  
  
• Tell your caregiver if you have had surgery on your lower back, or have problems with blood clotting. If you are female, tell your caregiver if you know or think that you might be pregnant.
  
  
• You may need to follow a low fiber diet to help prevent your wound from getting infected by stool after surgery. Ask caregivers about directions for eating and drinking.
  
  
• You may need to have a computed tomography (CT) scan, magnetic resonance imaging (MRI) and x-ray of your coccyx before surgery. Ask your caregiver for information about the tests that you need to have. Write down the date, time, and location of each test.
  
  
• You may be given an enema to empty your bowel before surgery. Ask your caregiver what to do to prepare your bowel for surgery.

The night before your surgery:

• Remove any nail polish.
  
  
• You may be given medicine to help you sleep.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your surgery. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before surgery. You may need to check your blood sugar more often before and after having surgery.
  
  
• You have a fever.

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• If you wear contact lenses, do not wear them on the day of your procedure or surgery. Glasses may be worn.
  
  
• Do not wear tight-fitting clothes on the day of your procedure or surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

• You will be asked to change into a hospital gown. You will be brought on a stretcher to the operating room. You will be given general anesthesia to keep you asleep during your surgery. You will lie face down with your hips and knees slightly bent for surgery. A caregiver will clean your lower back area. The cheeks of your buttocks will be separated and kept open with surgical tape. Clean sheets will be put on you.
  
  
• An incision (cut) will be made on your lower back, a few inches above the opening of your anus. Tissues and muscles will be cut and separated to reach the damaged or broken coccyx. Your caregiver will remove all or a part of your coccyx. The bones of your coccyx that have been taken may be sent to the lab for tests. Blood vessels, nerves, and ligaments near the coccyx will be checked and repaired if they are damaged. A drain may be placed to drain fluids from the area. Your wound will be closed with sutures (stitches).

After your surgery:

You will be taken to a room where you can rest. Caregivers will check on you. You may be allowed to get out of bed and walk as soon as you are able to without too much pain. When caregivers see that you are ready, you may be able to go home. If you are staying in the hospital, you will be taken to your hospital room. Do not get out of bed until your caregiver says it is OK. A bandage will cover your stitches. This bandage keeps the area clean and dry to help prevent infection. A caregiver may remove the bandage soon after your surgery to check the area.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your surgery on time.
  
  
• You have a fever.
  
  
• You have a skin infection or an infected wound near the area where the surgery will be done.

Seek Care Immediately if

• The pain in your lower back gets worse.
  
  
• You have difficulty breathing all of a sudden.
  
  
• You have more trouble having bowel movements.
  
  
• You have pain with sexual intercourse.
  
  
• You have trouble urinating.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Coccygectomy (Precare)