增生疗法
增生注射疗法(即,形成增生性瘢痕的治疗)通过注射炎性物质造成医源性的瘢痕形成,使得瘢痕形成和关节稳定。[40]Khan SA, Kumar A, Varshney MK, et al. Dextrose prolotherapy for recalcitrant coccygodynia. J Orth Surg (Hong Kong). 2008;16:27-29.http://www.ncbi.nlm.nih.gov/pubmed/18453654?tool=bestpractice.com将葡萄糖和2%利多卡因在透视引导下注射到尾骨最痛的点。15天后注射第二次,4周后可选择行第3次注射。目前尚无随机对照试验。在治疗特发性尾骨痛方面,这一方法的结果优于尾骨切除术。[8]Bayne O, Bateman JE, Cameron HU. The influence of etiology on the results of coccygectomy. Clin Orthop Relat Res. 1984;190:266-272.http://www.ncbi.nlm.nih.gov/pubmed/6488643?tool=bestpractice.com
奇神经节注射
骶前交感神经链在骶尾部连接处融合形成一个单一的神经节,即奇神经节(瓦尔特节)。有小样本的病例报道在透视引导下向神经节注射利多卡因或布比卡因用于治疗尾骨痛已获得成功,偶见起效时间较长,需重复注射。[41]Foye P, Buttaci CJ, Stitik TP, et al. Successful injection for coccyx pain. Am J Phys Med Rehabil. 2006;85:783-784.http://www.ncbi.nlm.nih.gov/pubmed/16924191?tool=bestpractice.com[42]Buttaci CJ, Foye PM, Stitik TP. Coccydynia successfully treated with ganglion impar blocks: a case series. Am J Phys Med Rehabil. 2005;84:218.