ÇOCUKLUK ÇAĞI YAŞ GRUBUNDA KOKSİKS MORFOLOJİSİNİN MRG İLE DEĞERLENDİRİLMESİ

AMAÇ: Koksiks, vertebral kolonun distalinde yer alan, sakrum alt ucu ile eklem yapan ve sıklıkla 3 veya 4 vertebral segmentten oluşan üçgen şeklinde bir kemiktir. Bu çalışmanın amacı çocukluk çağı yaş grubunda koksiks morfolojisinin ve morfometrisinin manyetik rezonans görüntüleme (MRG) ile değerlendirilmesidir.GEREÇ VE YÖNTEM: Bu retrospektif çalışmada, Ocak 2020- Ocak 2021 tarihleri arasında hastanemizde lumbosakral veya pelvik MRG ile tetkik edilmiş olan çocuk hastalar çalışmaya dahil edildi. Sakral ve koksigeal vertebraların en iyi şekilde görüntülendiği mid-sagittal, T1 ağırlıklı MRG kesitlerinde vertebraların dizilimleri, listezis varlığı/yokluğu ve koksiks vertebra sayısı kaydedildi. Ayrıca aynı kesitte morfometrik değerlendirmede doğrusal koksiks uzunluğu, sakrokoksigeal açı, sakrokoksigeal eklem açısı ve interkoksigeal açı ölçüldü.BULGULAR: Toplam 47 hasta (36 kız, 11 erkek) çalışmaya dahil edildi. Hastaların yaş ortalaması 13.7±2.1 idi. Kız ve erkek hasta-lar arasında ve farklı yaş grupları arasında (grup 1: 7-10 yaş, grup 2: 11-13 yaş, grup 3: 14-16 yaş); koksiks uzunluğu, sakrokoksi-geal açı, sakrokoksigeal eklem açısı, interkoksigeal açı arasında anlamlı fark saptanmadı (sırasıyla; p= 0,728, p=0,262, p=0,105 ve p=0.191, p= 0.684, p=0.927).SONUÇ: Bu çalışmaya göre çocukluk çağı yaş grubunda sakrokoksigeal açı, sakrokoksigeal eklem açısı ve interkoksigeal açılar değerlendirildiğinde kız ve erkek hastalar arasında ve farklı yaş grupları arasında farklılık saptanmamıştır. Çocukluk çağı yaş grubunda koksikse ait morfolojik özelliklerin bilinmesi, hastalıkların değerlendirilmesinde kolaylık sağlayacaktır.

Anahtar Kelimeler:

Koksiks, Çocuk, Manyetik Rezonans Görüntüleme.

EVALUATION OF COCCYX MORPHOLOGY WITH MAGNETIC RESONANCE IMAGING IN CHILDHOOD AGE

OBJECTIVE: The coccyx is a triangular bone located in distal of the vertebral column, articulating with the lower end of the sacrum, and often consisting of 3 or 4 vertebral segments. The aim of this study is to evaluate coccyx morphology and morphometry in the childhood age group with magnetic resonance imaging (MRI).MATERIAL AND METHODS: In this retrospective study, children who had lumbosacral or pelvic MRI in our hospital between January 2020 and January 2021 were included. In mid-sagittal, T1-weighted MRI sections, where the sacral and coccygeal vertebrae are best visualized, the alignment of the vertebrae, the presence/absence of listezis, and the number of coccyx vertebrae were recorded. In addition, linear coccyx length, sacrococcygeal angle, sacrococcygeal joint angle and intercoccygeal angle were measured in the same section in the morphometric evaluation.RESULTS: A total of 47 patients (36 girls, 11 boys) were included in the study. The mean age of the patients was 13.7±2.1. Among female and male patients and between different age groups (group 1: 7-10 years, group 2: 11-13 years, group 3: 14-16 years); There was no significant difference between coccyx length, sacrococcygeal angle, sacrococcygeal joint angle, and intercoccygeal angle (p= 0.728, p=0.262, p=0.105 and p=0.191, p= 0.684, p=0.927, respectively).CONCLUSIONS: According to this study, when the sacrococcygeal angle, sacrococcygeal joint angle and intercoccygeal angles were evaluated in the childhood age group, no difference was found between male and female patients and between different age groups. Knowing the morphological features of the coccyx in the childhood age group will facilitate the evaluation of diseases.

Keywords:

Coccyx, Child, Magnetic Resonance Imaging.,

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1. Drake R, Vogl A, Mitchell A. Gray’s anatomy for students 2nd ed. Philadelphia: Churchill Livingstone. 2009:348-381.
2. Lirette LS, Chaiban G, Tolba R, Eissa H. Coccydynia: an overview of the anatomy, etiology, and treatment of coccyx pain. Ochsner Journal. 2014;14(1):84-87.
3. Mouhsine E, Garofalo R, Chevalley F, et al. Posttraumatic coccygeal instability. The Spine Journal. 2006;6(5):544-549.
4. Nathan S, Fisher B, Roberts C. Coccydynia: a review of pathoanatomy, aetiology, treatment and outcome. Journal Bone Joint Surg Br. 2010;92(12):1622-7.
5. Kerimoglu U, Dagoglu MG, Ergen FB. Intercoccygeal angle and type of coccyx in asymptomatic patients. Surgical and Radiologic Anatomy. 2007;29(8):683-687.
6. Lee JY, Gil YC, Shin KJ, et al. An Anatomical and Morphometric Study of the Coccyx Using Three‐Dimensional Reconstruction. The Anatomical Record. 2016;299(3):307-312.
7. Yoon MG, Moon M-S, Park BK, et al. Analysis of sacrococcygeal morphology in Koreans using computed tomography. Clinics in Orthopedic Surgery. 2016;8(4):412.
8. Maigne J, Pigeau I, Aguer N, Doursounian L, Chatellier G. Chronic coccydynia in adolescents. A series of 53 patients. European Journal of Physical and Rehabilitation Medicine. 2011;47(2):245-251.
9. Postacchini F, Massobrio M. Idiopathic coccygodynia. Analysis of fifty-one operative cases and a radiographic study of the normal coccyx. J Bone Joint Surg Am. 1983;65(8):1116-1124.
10. Skalski MR, Matcuk GR, Patel DB, Tomasian A, White EA, Gross JS. Imaging coccygeal trauma and coccydynia. RadioGraphics. 2020;40(4):1090-1106.
11. Indiran V, Sivakumar V, Maduraimuthu P. Coccygeal Morphology on Multislice Computed Tomography in a Tertiary Hospital in India. Asian Spine Journal. 2017;11(5):694.
12. Woon JT, Perumal V, Maigne J-Y, Stringer MD. CT morphology and morphometry of the normal adult coccyx. European Spine Journal. 2013;22(4):863-870.
13. Özkal B, Avnioğlu S, Candan B. Morphometric evaluation of coccyx in patients with coccydynia and classification. Acta Medica Alanya. 2020;4(1):61-67.
14. Tetiker H, Koşar Mİ, Çullu N, Canbek U, Otağ I, Taştemur Y. MRI-based detailed evaluation of the anatomy of the human coccyx among Turkish adults. Nigerian Journal of Clinical Practice. 2017;20(2):136-142.
15. Woon JT, Maigne J-Y, Perumal V, Stringer MD. Magnetic resonance imaging morphology and morphometry of the coccyx in coccydynia. Spine. 2013;38(23):E1437-E1445.
16. Saluja P. The incidence of ossification of the sacrococcygeal joint. Journal of Anatomy. 1988;156:11-5.