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Case Reports
. 2018 Oct 17;2018(10):rjy276.
doi: 10.1093/jscr/rjy276. eCollection 2018 Oct.

Bertolotti's syndrome: an underdiagnosed cause for lower back pain

Francisco Alonzo  1 , Andres Cobar  2 , Mario Cahueque  2 , Jose Antonio Prieto  1
Affiliations
Case Reports

Bertolotti's syndrome: an underdiagnosed cause for lower back pain

Francisco Alonzo et al. J Surg Case Rep. .

Abstract

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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Figures

Figure 1:
Figure 1:
Radiographs showing an overdeveloped left transverse process, which contacts with the sacrum left sacral wing (Castelvi’s Type IIa).
Figure 2:
Figure 2:
RMN of the patient showing smaller facets in the anomalous articulation and healthy disc compared to the supradjacent one (next figure).
Figure 3:
Figure 3:
Degenerative changes at the facets and disc in the adjacent segment.
Figure 4:
Figure 4:
Showing the protective effect of the limitation of the motion in the distal disc to the anomaly.
Figure 5:
Figure 5:
Showing the protective effect of the limitation of the motion in the distal disc to the anomaly.
See this image and copyright information in PMC

References

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