Abstract
Context: Focal sympathetic nerve blocks of the ganglion impar are often effective treatments
for coccydynia (coccyx pain) and other pelvic pain syndromes. These injections are
generally performed under contrast-enhanced fluoroscopic guidance. Vascular uptake
may potentially occur during the injection and vascular uptake rates have been reported
for other spinal injections, but never for ganglion impar blocks. Aims: The purpose of the study was to determine vascular uptake rates during fluoroscopy-guided
ganglion impar blocks. Settings and Design: An academic/University-based Coccyx Pain Center. Methods and Materials: A total of 78 consecutive trans-coccygeal ganglion impar blocks were analyzed for
vascular uptake of contrast as determined by intermittent fluoroscopy. Statistical Analysis Used: Direct calculation of incidence. Results: Only one patient (1.3%) demonstrated a vascular uptake pattern, which was readily
recognized and corrected by slightly adjusting the position of the needle tip and
thereby subsequently obtaining the desired contrast pattern at the ganglion impar.
Conclusions: Vascular uptake incidence is low during ganglion impar blocks. This information
can be one of the multiple factors considered when a physician is deciding whether
or not to use contrast in an individual patient.
Keywords
Coccydynia - coccyx pain - ganglion impar - sympathetic nerve block - vascular uptake
