case_images: PMC11471190_01
case_images: Preoperative coronal and sagittal x-rays demonstrating subluxed sacrococcygeal joint (red arrow).
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case_images: PMC11471190_01_gr1.jpg
case_images: fig1
case_images: Review of the pelvic X-rays by the surgeon demonstrated a clear dislocation of the sacrococcygeal joint (Fig. 1).
case_images: (a) Exoscope system setup. (b) View of surgical field for exoscope assisted coccygectomy using 22 mm diameter METRX retractors.
case_images: gr2.jpg
case_images: PMC11471190_01_gr2.jpg
case_images: fig2
case_images: Employing the Synaptive exoscope-microscope system, microsurgical dissection was performed to meticulously expose the posterior elements of the S5, C1, C2, and C3 segments (Fig. 2).
case_images: (a) Intraoperative localization with hypodermic needle. (b) Intraoperative localization with lateral fluoroscopic X-rays.
case_images: gr3.jpg
case_images: PMC11471190_01_gr3.jpg
case_images: fig3
case_images: An intraoperative C-arm fluoroscopy confirmed correct anatomical localization (Fig. 3).
case_images: (a) Intraoperative view of coccyx through exoscope (b) Use of angled curette to dissect the coccyx en bloc from the surrounding myofascial attachments.
case_images: gr4.jpg
case_images: PMC11471190_01_gr4.jpg
case_images: fig4
case_images: A combination of low-power monopolar cautery and the use of angled curettes enabled the delicate separation of soft tissues and the en bloc removal of the C1, C2, and C3 segments (Fig. 4). Fig. 6 shows the wound at 4 weeks post-operation.
case_images: Resected coccyx.
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case_images: PMC11471190_01_gr5.jpg
case_images: fig5
case_images: Following the excision (Fig. 5), the surgical team conducted a thorough inspection of the retroperitoneal space and achieved thorough hemostasis.
case_images: (a) Surgical site at four-week post-operative follow up. (b) Post-operative coronal and sagittal x-rays showing absence of the coccyx.
case_images: gr6.jpg
case_images: PMC11471190_01_gr6.jpg
case_images: fig6
case_images: Fig. 6 shows the wound at 4 weeks post-operation.