Coccygeal Morphology on Multislice Computed Tomography in a Tertiary Hospital in India

Asian Spine J. 2017 Oct;11(5):694-699. doi: 10.4184/asj.2017.11.5.694. Epub 2017 Oct 11.


Study design: A retrospective, cross-sectional study of 213 patients who presented for abdominal computed tomography (CT) scans to assess coccygeal morphology in the Indian population.

Purpose: There have been relatively few studies of coccygeal morphology in the normal population and none in the Indian population. We aimed to estimate coccygeal morphometric parameters in the Indian population.

Overview of literature: Coccygeal morphology has been studied in European, American, Korean, and Egyptian populations, with few differences in morphology among populations.

Methods: A retrospective analysis of 213 abdominal CT scans (114 males and 99 females; age, 7-88 years; mean age, 47.3 years) was performed to evaluate the number of coccygeal segments, coccyx type, sacrococcygeal and intercoccygeal fusion and subluxation, coccygeal spicules, sacrococcygeal straight length, and sacrococcygeal and intercoccygeal curvature angles. Results were analyzed for differences in morphology with respect to sex and coccyx type.

Results: Types I and II coccyx were the most common. Most subjects had four coccygeal vertebrae; 93 subjects (43.66%) had partial or complete sacrococcygeal fusion. Intercoccygeal fusion was common, occurring in 193 subjects. Eighteen subjects had coccygeal spicules. The mean coccygeal straight length was 33.8 mm in males and 31.5 mm in females; the mean sacrococcygeal curvature angle was 116.6° in males and 111.6° in females; the mean intercoccygeal curvature angle was 140.94° in males and 145.10° in females.

Conclusions: Type I was the most common coccyx type in our study, as in Egyptian and Western populations. The number of coccygeal vertebrae and prevalence of sacrococcygeal and intercoccygeal fusion in the Indian population were similar to those in the Western population. The mean coccygeal straight length and mean sacrococcygeal curvature angle were higher in males, whereas the intercoccygeal curvature angle was higher in females. Information on similarities and differences in coccygeal morphology between different ethnic populations could be useful in imaging and treating patients presenting with coccydynia.

Keywords: Angle; Coccyx; Computed tomography; Sacrococcygeal.