Morphological evaluation of the coccyx with multidetector computed tomography

Surg Radiol Anat. 2019 Dec;41(12):1519-1524. doi: 10.1007/s00276-019-02325-5. Epub 2019 Sep 6.


Purpose: This study aims to evaluate the morphology of the coccyx in adults with multidetector computed tomography and to contribute to the classification of the coccyx using intercoccygeal and sacrococcygeal angle measurements.

Methods: The pelvic computed tomography images of 224 patients were retrospectively evaluated. The multiplanar reconstruction and 3D volume rendering images of the coccyx were obtained from all patients at sagittal and coronal planes. The morphology of the coccyx, number of bone segments, the presence of scoliosis, and presence of sacrococcygeal and intercoccygeal fusion were evaluated. After the measurement of coccygeal length, width, and thickness, intercoccygeal and sacrococcygeal angles were also calculated in all patients.

Results: The morphological classification showed that 136 patients (60.7%) had type 1, 65 patients (29%) had type 2, and 17 patients (7.6%) had type 3 coccyx. The intercoccygeal angle was zero degree in five patients (type 0) and one patient had retroverted coccyx (type 5). The coccyx had four segments in 155 patients (69.2%), three segments in 52 patients (23.2%), five segments in 15 patients (6.7%), two segments in one patient (0.4%), and one segment in one patient (0.4%).

Conclusion: We determined patients with an intercoccygeal angle of zero degree, which is not mentioned in the literature before, and we propose to use the term "type 0" for these patients in the classification of coccyx. The coccygeal measurements and classification will be instructive for the radiologists and have a guiding role for the future studies.

Keywords: Anatomic variation; Coccyx; Morphological findings; Multidetector computed tomography.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Coccyx / anatomy & histology*
  • Coccyx / diagnostic imaging
  • Female
  • Humans
  • Imaging, Three-Dimensional*
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Retrospective Studies
  • Sacrum / anatomy & histology*
  • Sacrum / diagnostic imaging
  • Young Adult