One Ganglion Impar injection achieved over 50% improvement for 82% of cases that lasted an average of 6 months.
Pain Relief due to Transsacrococcygeal Ganglion Impar Block in Chronic Coccygodynia: A Pilot Study
Osman Hakan Gunduz, Savas Sencan, Ozge Kenis-Coskun.
Pain Medicine 2015 in press
- 22 cases not responding to conservative therapy
- fluoroscopy-guided transsacrococcygeal ganglion impar block – “With the patient lying prone, the sacrococcygeal joint was visualized via fluoroscopy. A 22-gauge spinal needle was used to reach the ganglion impar. After injection of contrast material and confirming the position of needle, 2 mL of 0.5% bupivacaine, 2 mL
saline, and 1 mL (40 mg) of methylprednisolone were injected in the area.”
- Results were so good I included table here:
Comment – I have written on ganglion impar injections before:
- ganglion is more often 1 coccyx segment down from sacrococcygeal joint so injection there might be better
- Don’t need a spinal needle unless fat. In a thin lady I felt a 30 gauge needle just penetrate . 25 guage 1-1/4 inch might do unless significantly obese for many.
- If not using imaging, just put on cipro 1 gm/day for 3 days if rectal examining after shows blood
- I am however cannot responsible for individual cases where more care might be warranted.
- I have just used 5% lidocaine without steroid and that might be bit safer but probably needs repeating 3 times for good take.