SYSTEMATIC REVIEW article
Front. Musculoskelet. Disord.
Sec. Spine Conditions
This article is part of the Research TopicAdvancements and Optimization of Evidence-Based Approaches in Pain ManagementView all 13 articles
Clinical evaluation and treatment of Coccygodynia with percutaneous procedures on Walther's Impar Ganglion. Scooping review
Provisionally accepted
Juan Carlos ACEVEDO-GONZALEZ1,2*
Daniela Carolina RAMOS-CLAVIJO1Javier Gustavo ROMERO-LOPEZ1Juan Alejandro OLMOS-MUNEVAR1Isabella LACOUTURE-SILGADO1- 1Pontificia Universidad javeriana Facultad de Medicina, BOGOTA, Colombia
- 2Hospital Universitario San Ignacio, BOGOTA, Colombia
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Objectives: Coccygodynia is pain located in the coccyx region caused by a variety of abnormalities. It has a prevalence in the general population of up to 3% and its treatment is not always effective. This study aims to perform a review of the literature to evaluate the efficacy and safety of procedures directed at the Walther ganglion impar for the treatment of chronic Coccygodynia. Materials and methods: the principles recommended by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) were used. Search words: "ganglion impar block", "Coccyx injection", "Presacral neurolytic block", "Superior hypogastric plexus block", "Inferior hypogastric plexus", "Walther block", "Coccydynia", "Pelvic chronic pain", "Coccygodynia". Databases: Pubmed, Scopus, Embase, Ovid, EBSCO host and google scholar. Period: from the beginning of the database until November 2025. Each author independently reviewed the abstract of all articles found and applied the following inclusion criteria: Systematic literature review, clinical trials, observational studies and case series. Exclusion: Experimental articles. Results: There were 47 articles included (5 systematic reviews, 6 randomized clinical trials, 6 prospective studies, 22 retrospective studies, 8 clinical case presentations). The Prisma checklist for systematic reviews was applied and the quality of each of the articles was assessed using the STROBE, GRADE and CONSORT checklists. Conclusions: Coccygodynia is a painful symptom in the coccyx region that requires an adequate clinical and radiological evaluation to determine the exact cause of the pain. Conservative techniques can be used in the early stages of pain, but percutaneous procedures targeting GIW allow for adequate symptom control. Pelvic floor muscle rehabilitation will allow for long-lasting clinical results.
Keywords: Ganglion impar block, Coccyx injection, Presacral neurolytic block, superior hypogastric plexus block, inferior hypogastric plexus, Walther block, Coccygodynia, Pelvic chronic pain
Received: 09 Sep 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 ACEVEDO-GONZALEZ, RAMOS-CLAVIJO, ROMERO-LOPEZ, OLMOS-MUNEVAR and LACOUTURE-SILGADO. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Juan Carlos ACEVEDO-GONZALEZ, jacevedog@gmail.com
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