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Neurol Neurochir Pol. 2018 Sep - Oct;52(5):612-617. doi: 10.1016/j.pjnns.2018.08.006. Epub 2018 Aug 28.

Ganglion Impar block improves neuropathic pain in coccygodynia: A preliminary report.

Author information

1
Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
2
Department of Physical Medicine and Rehabilitation, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey. Electronic address: ozgekenis@gmail.com.
3
Department of Physical Medicine and Rehabilitation, Kayseri Training and Research Hospital, Kayseri, Turkey.
4
Department of Physical Medicine and Rehabilitation, Adiyaman University Training and Research Hospital, Adiyaman, Turkey.
5
Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.

Abstract

AIM OF THE STUDY:

To define the effectiveness of ganglion Impar block in improving neuropathic pain.

MATERIALS AND METHODS:

Patients who had pain around the coccyx for more than three months and did not respond to conservative treatment were included in this study. All the patients underwent fluoroscopy guided transsacrococcygeal ganglion Impar block with injecting 3 mL of 0.5% bupivacaine, 2 mL saline, and 1 mL (40 mg) of methylprednisolone. Patients were evaluated with visual analog scale (VAS) for pain, Leeds assessment of neuropathic symptoms and signs scale (LANSS) for neuropathic pain, Beck depression Inventory (BDI) for mood and Short-form 12 (SF-12) for quality of life before, 1 month 3 months and 6 months after the injection. Patients' painless sitting duration was also recorded.

RESULTS:

A total of 28 patients were included in the final analyses. VAS and LANSS scores improved significantly throughout the follow-up periods. BDI scores also improved while SF-12 scores did not show significant changes. Painless sitting period of the patients' improved significantly.

CONCLUSIONS:

Ganglion Impar block is effective in decreasing the neuropathic component of chronic coccygodynia. This improves painless sitting in patients but its reflections on quality of life is not clear.

KEYWORDS:

Coccygodynia; Ganglion Impar; Neuropathic pain; Sympathetic block

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