Anterior pseudoarthrectomy for symptomatic Bertolotti’s syndrome

Malham, Gregory M.; Limb, Rebecca; Claydon, Matthew H.; Brazenor, G. A.

doi:10.1016/j.jocn.2013.02.018

Cited by 20 publications

(17 citation statements)

References 8 publications

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“…Although the exact cause of this syndrome is unclear, the following etiologies have been put forward: (1) articulation of the transverse process and sacral ala [1, 4, 5, 11, 16]; (2) degeneration of the intervertebral disc at adjacent levels [10]; (3) facet joint contralateral to a unilateral fused or articulating LSTV [7]; and (4) extraforaminal stenosis secondary to the presence of a hypertrophied transverse process [8, 12, 17]. …”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Microendoscopic Resection of the Transverse Process for Treatment of Low Back Pain with Bertolotti’s Syndrome

Takata

Sakai

Higashino

et al. 2014

Case Reports in Orthopedics

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Bertolotti's syndrome is characterized by anomalous enlargement of the transverse process of the most caudal lumbar segment, causing chronic and persistent low back pain or sciatica. We describe the case of a 45-year-old woman who presented with left sciatic pain and low back pain due to a recurrent lumbar disc herniation at L4-5 with Bertolotti's syndrome. Selective L5 nerve root block and local injection of lidocaine into the articulation between the transverse process and sacral ala temporarily relieved the left sciatic pain and low back pain, respectively. To confirm the effect of local injection on low back pain, we gave a second local injection, which once again relieved the low back pain. Microendoscopic resection of the pseudoarticulation region and discectomy successfully relieved all symptoms. This report illustrates the effectiveness of minimally invasive resection of the transverse process for the treatment of low back pain with Bertolotti's syndrome.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Microendoscopic Resection of the Transverse Process for Treatment of Low Back Pain with Bertolotti’s Syndrome

Takata

Sakai

Higashino

et al. 2014

Case Reports in Orthopedics

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“…Mario Bertolotti reported the association of LSTV with low back and sciatic pain in 1917 2 . Some researchers have reported surgical procedures to alleviate the situation, including anterior or posterior decompression with or without unilateral or bilateral fixation 3–6 . Burnham 7 reported the use of thermal radiofrequency (RF) for treating patients with Bertolotti’s syndrome (BS) presenting only with low back pain.…”

Section: Figurementioning

confidence: 99%

“…PRF could potentially have a biological effect on the nerve endings from lumbosacral nerves that have been sprouting into the pseudoarthrosis 10 . Because nuclear medicine imaging has demonstrated increased tracer uptake at the site of pseudarthrosis, 11,12 immune modulation and attenuation of proinflammatory cytokines are assumed through the electrical field 10 . We have used thermal RF for several kinds of disorders such as facet pain, sacroiliac joint pain, and trigeminal neuralgia for about 30 years.…”

Section: Figurementioning

confidence: 99%

Pulsed Radiofrequency Treatment for Bertolotti’s Syndrome Presenting With Low Back Pain: Report of Four Cases

et al. 2020

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“…The mechanism that BS causes pain is diverse. Some studies indicated that it was caused by the degeneration of pseudo-articulation between a LSTV and an ala of sacrum [13][14][15] . It was also proved that the pain came from L5 nerve root entrapment by extraforaminal stenosis on account of enlarged TP of LSTV, called far out syndrome [16][17][18][19] .…”

Section: Operative Techniquementioning

confidence: 99%

“…And the authors pointed out that the results with posterolateral fusion were only slightly better than those with conservative treatment in a comparable group. Whereas, many authors reported favorable results of technique to simply resect the pseudo-articulation or decompress entrapment of the L5 nerve root [6][7][8]13,[24][25][26] . Some of them reported minimal invasive technique using a tubular retractor and suggested that it was recommended as an effective procedure.…”

Section: Operative Techniquementioning

confidence: 99%

Percutaneous Full Endoscopic Transverse Processectomy for Bertolotti’s Syndrome

Yoo

Kim

et al. 2019

J Minim Invasive Spine Surg Tech

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The Lumbosacral transitional vertebra (LSTV) is a congenital anomaly and has two types of abnormal vertebrae. Low back pain and leg pain originated from a lumbosacral transitional vertebra (LSTV) known as Bertolotti's syndrome (BS). We describe our institution's experience of a L5 transverse processectomy done via a percutaneous endoscopic approach for a patient with Bertolotti's syndrome. A 64year-old female patient with persistent left leg radiating pain visited at the spine center. This patients underwent endoscopic L5-S1 foraminoplasty under the diagnosis of foraminal stenosis. However, despite the complete neural decompression, the patient complained of persistent left leg pain. We found that the left transverse process (TP) of L5 vertebra seemed to contact with the ala of sacrum suggesting the Bertolotti's syndrome (BS). A pseudo-articulation lidocaine injection was given and it was effective in reducing the leg pain. Under local anesthesia, a uniportal endoscopy was introduced to the base of the L5 TP and simply cut in cranial to caudal direction using a high-speed drill in order to block the way of mechanical stress from spine. The patient's symptoms got relieved after L5 transverse processectomy and she was discharged in a few days.

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Anterior pseudoarthrectomy for symptomatic Bertolotti’s syndrome

Cited by 20 publications

References 8 publications

Minimally Invasive Microendoscopic Resection of the Transverse Process for Treatment of Low Back Pain with Bertolotti’s Syndrome

Minimally Invasive Microendoscopic Resection of the Transverse Process for Treatment of Low Back Pain with Bertolotti’s Syndrome

Pulsed Radiofrequency Treatment for Bertolotti’s Syndrome Presenting With Low Back Pain: Report of Four Cases

Percutaneous Full Endoscopic Transverse Processectomy for Bertolotti’s Syndrome

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