Chronic Coccygodynia and ganglion impar block: How does contrast material distribution affect treatment outcomes?

Abstract

To assess the influence of contrast material distribution patterns on treatment success in patients with chronic coccygodynia undergoing ganglion impar block (GIB). An evaluation was conducted on 58 patients who underwent GIB from August 2021 to August 2023 at a university hospital's interventional pain management center. Numeric rating scale (NRS) scores were recorded before the procedure and at 1-month post-procedure. The patients were categorized into two groups based on treatment success, defined as at least a 50% reduction in the NRS score at 1 month. There were no significant differences between the two groups regarding age, gender, BMI, symptom duration, comorbidities, coccyx curvature type, presence of anterior/posterior subluxation, presence of posterior spicule, type of approach, contrast distribution direction, and contrast dye level. Patients with coccygodynia experienced statistically significant benefits from GIB treatment at the 1-month follow-up (p < 0.001). Although the use of contrast material in fluoroscopic procedures is the gold standard to prevent possible complications, the distribution pattern of contrast does not significantly affect the success of GIB treatment in patients with coccygodynia. Further prospective and long-term follow-up studies are required to validate these findings.