Bertolotti’s Syndrome

A “pseudo” joint can be the cause of low back pain.

Mahmoodreza Torkaman, MD;

Anand Prem, MD

 

Introduction:

Lumbosacral transitional vertebra (LSTV) as a cause of low back pain was first described in 1917 by Bertolotti.His initial description postulated low back pain caused by arthritic changes occur at the site where an enlarged transverse process articulated with the sacrum, termed a “pseudarthrosis”.

 

Materials and Methods:

This is a case report, devoid of the patient's identifiable information.

 

Results/Case Report:

-A 50-year-old male  with a history of low back pain for several years who failed conservative therapy

-The T2-weighted coronal MRI showed a transitional lumbosacral junction through enlargement of the "L5" transverse process articulating with the sacral alae forming a “pseudo-articulation”.

-The Patient had localized tenderness over the Left lumbar paravertebral area above the PSIS

-The patient treated with an injection of pseudoarticulation reported almost complete pain relief, which lasted about 6 months.  returned for 3 more similar blocks over the past 2 years

 

Discussion:

-As there is controversy about the significance of LSTV as a cause of low back pain, there is still a lack of consensus regarding the best way to treat these patients.

-Other treatments include radiofrequency ablation of the anomalous diarthrodial joint, posterior surgical fusion of the pseudarthrosis, and resection of the enlarged transverse process