Transitional lumbosacral vertebrae and low back pain: diagnostic pitfalls and management of Bertolotti's syndrome

OBJECTIVE: Bertolotti's syndrome is a spine disorder characterized by the occurrence of a congenital lumbar transverse mega-apophysis in a transitional vertebral body that usually articulates with the sacrum or the iliac bone. It has been considered a possible cause of low back pain. METHOD: We analyzed the cases of Bertolotti's syndrome that failed clinical treatment and reviewed the literature concerning this subject. RESULTS: Five patients in our series had severe low back pain due to the neo-articulation and two of them were successfully submitted to surgical resection of the transverse mega-apophysis. Taking into account the clinical and surgical experience acquired with these cases, we propose a diagnostic-therapeutic algorithm. CONCLUSION: There is still no consensus about the most appropriate therapy for Bertolotti's syndrome. In patients in whom the mega-apophysis itself may be the source of back pain, surgical resection may be a safe and effective procedure.

Bibliographic Details

Main Authors:	Almeida,Daniel Benzecry de, Mattei,Tobias Alécio, Sória,Marília Grando, Prandini,Mirto Nelso, Leal,André Giacomelli, Milano,Jerônimo Buzzeti, Ramina,Ricardo
Format:	Digital revista
Language:	English
Published:	Academia Brasileira de Neurologia - ABNEURO 2009
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2009000200018
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