The coccyx consists of 3-5 fused or partially fused vestigial vertebrae forming the terminal segment of the vertebral column. Co1 (the first coccygeal segment) retains rudimentary transverse processes and cornu that articulate with the sacral cornu at the sacrococcygeal joint. The coccyx provides attachment for the levator ani, coccygeus, anococcygeal ligament, and gluteus maximus.
Coccyx fractures and dislocations from falls cause coccydynia, producing pain with sitting, rising from seated, and defecation. Lateral X-ray in sitting and standing positions assesses coccygeal mobility and dislocation. The coccyx is normally slightly mobile and a flexion angle greater than 25 degrees indicates hypermobility. Coccygectomy is performed for refractory coccydynia after failed conservative treatment and injections.
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