To determine the demographic, pre-operative, operative, post-operative, and outcome in seven patients who presented to our unit over a 5-year period and underwent a coccydectomy for coccydynia unresponsive to conservative measures.

We performed a retrospective chart review of seven patients who presented to the Department of Orthopaedics at Helen Joseph hospital, University of the Witwatersrand, Johannesburg, South Africa, with coccidia unresponsive to a trial of adequate conservative measures, and underwent operative intervention. The study period was from 01 January 2014 to 31 December 2018.

The mean age of subjects in our study was 53 years. The average length of conservative treatment prior to presentation to our unit was 8 months. All patients were taken to surgery and the mean length of surgery was 49 min and the mean volume of intra-operative blood loss was 63.4 ml. In all 7 (100%) of subjects a total coccygectomy was performed. At our 1-year end point all 7 (100%) subjects reported a favourable outcome and were satisfied – extremely satisfied with the procedure.

In our study a total coccygectomy resulted in a significant reduction in coccygeal pain and subjects a 1-year follow-up end point. We recommend that in patients who fail an adequate recognized trial of conservative measures for coccydynia, a total coccygectomy should be performed.