Bertolotti's syndrome refers to the presence of pain associated to the anatomical variant of sacralization of the last lumbar vertebra. It is often a factor that is not addressed in the evaluation and treatment of lower back pain. The presence of a lumbosacral transitional vertebra is a common finding among general population with a prevalence that ranges between 4 and 30%, however, this finding is rarely associated to the cause of lower back pain and thus, the prevalence of Bertolotti's syndrome in general population is unknown doe to underdiagnosis. The sacralization of the fifth lumbar vertebra has been related to changes in the anatomy and biomechanics of the spine with no general agreement to its clinical significance, however Bertolotti's syndrome should be considered as a differential diagnosis for lower back pain, therefore, its pathophysiology, epidemiology and treatment must be a topic of general knowledge to physicians that often treat this condition.
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| http://dx.doi.org/10.1093/jscr/rjy276 | DOI Listing |
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An update on the prevalence and management of Bertolotti's syndrome.
Front Surg
December 2024
Cantor Spine Center at the Paley Institute, West Palm Beach, FL, United States.
Bertolotti's Syndrome, a subset of lumbosacral transitional vertebrae (LSTV), is one cause of chronic low back pain (LBP), and a commonly overlooked differential diagnosis. The incidence of Bertolotti's Syndrome has been underestimated in the past and is common in those of younger ages around 30-40. Although diagnostics, imaging methods, and treatment algorithms have been improved in the past few years, there is no gold standard and more long-term, prospective research is needed.
View Article and Find Full Text PDFA Case of Endoscopic Partial Transverse Process and Sacral Alar Resection for Bertolotti's Syndrome and Continued Basketball Playing Two Years After Surgery.
Cureus
June 2024
Department of Orthopaedic Surgery, University of Tsukuba, Tsukuba, JPN.
Article Synopsis
- Bertolotti's syndrome occurs when the transverse process of the last lumbar vertebra enlarges and connects with the sacral alar, causing back pain, especially in athletes.
- An adolescent basketball player experienced persistent left low back pain, which did not improve with conservative treatments, leading to an endoscopic surgical procedure to resect the enlarged bone.
- Post-surgery, the patient reported immediate pain relief and successfully returned to basketball three months later, with positive outcomes and no complications noted one and two years after the operation.
Techniques in medicine: ipsilateral transforaminal epidural steroid injection in Bertolotti's syndrome.
Pain Manag
March 2024
UTHealth McGovern Medical School, Department of Anesthesia & Pain Medicine, Houston, TX 77030, USA.
Bertolotti's syndrome, also known as lumbosacral transitional vertebrae, is a relatively rare spinal condition characterized by an anatomical variation in the lower spine. Conservative approaches such as physical therapy, anti-inflammatory medications and lifestyle modifications may be recommended for mild cases. In more severe cases or when conservative measures fail to provide relief, injections such as may be considered to alleviate pain.
View Article and Find Full Text PDFRisks Associated with Surgical Management of Lumbosacral Transitional Vertebrae: Systematic Review of Surgical Considerations and Illustrative Case.
World Neurosurg
June 2024
Department of Neurological Surgery, University of California, Irvine, Orange, California, USA.
Background: Lumbosacral transitional vertebrae (LSTV) are congenital anomalies of the L5-S1 segments characterized by either sacralization of the most caudal lumbar vertebra or lumbarization of the most cephalad sacral vertebra. This variation in anatomy exposes patients to additional surgical risks.
Methods: In order to shed light on surgical considerations reported for lumbar spine cases involving LSTV as described in the extant literature, we performed a systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.
A Proposed Treatment Algorithm for Low Back Pain Secondary to Bertolotti's Syndrome.
Pain Physician
February 2024
Anesthesiology and Pain Medicine, University of Florida, Gainesville, FL.
Background: Chronic low back pain is widely prevalent, and there are a range of conditions that may result in the low back pain. In general, treatment of low back pain starts with conservative management such as medications, physical therapy, and home exercise regimens. If conservative measures fail, a range of interventional techniques can be employed to manage back pain.
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