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Paracoccygeal Corkscrew Approach to Ganglion Impar Injections for Tailbone Pain
Pain Practice, 06/05/09

Foye PM et al. - This article presents a new, paracoccygeal approach whereby the needle is inserted alongside the coccyx and the needle is guided through three discrete steps with a rotating or corkscrew trajectory. Compared with some of the previously published techniques, this paracoccygeal corkscrew approach has multiple potential benefits, including ease of fluoroscopic guidance using the lateral view, ability to easily use a stylet for the spinal needle, and use of a shorter, thinner needle. While no single technique works best for all patients and each technique has potential advantages and disadvantages, this new technique adds to the available options.

Exclusive Author Commentary
Patrick M. Foye, M.D., 06/05/09

Coccydynia (i.e., coccyx pain; tailbone pain) and other pelvic pain syndromes can substantially impair a patient's quality of life. The ganglion Impar is part of the sympathetic nervous system, located in the retrorectal space, anterior to the coccyx. Injections at this ganglion may help decrease pain and improve quality of life for some patients with tailbone pain and other pelvic pain syndromes. Ganglion Impar injections can include nerve blocks, steroid injections, or neurolytic lesions. Regardless of the technique used, many patients require repeat injections to maximize their benefit. There are various different techniques for performing Ganglion Impar injections, previously published by other authors and myself. The focus of this article is a new technique (paracoccygeal approach using a rotational, or corkscrew, trajectory). Our hope is that physicians will be aware of the various techniques so that they can choose the best approach for any given patient, and thereby provide patients with significant relief. --- Patrick Foye, M.D., Director, Coccyx Pain Service, UMDNJ: New Jersey Medical School, 90 Bergen St., DOC-3100, Newark NJ 07058. Phone # 973-972-2802. Fax # 973-972-2825. Website: www.TailboneDoctor.com

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