A novel approach to refractory coccydynia: ultrasound- fluoroscopy-guided cryoablation of sacrococcygeal nerve

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Abstract
Coccydynia, also termed chronic pain in the tailbone, is a complex condition with limited treatment options for refractory cases. This case series introduces a novel approach for treating refractory coccydynia using cryoablation of the sacrococcygeal nerves under combined ultrasound and fluoroscopy guidance. Two female patients, suffering from chronic pain for over six months and unresponsive to conservative interventions, underwent cryoablation. Both patients reported significant pain relief, with more than 50% reduction in their numeric rating scale scores, and no major complications were observed during or after the procedure. Furthermore, we propose a clinical treatment algorithm to assist in selecting appropriate interventions for refractory coccydynia, based on the anatomical source of the pain. The findings suggest that cryoablation may be a valuable option for patients with persistent coccygeal pain; however, larger prospective studies are required to confirm its efficacy and long-term safety.

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