Bertolotti syndrome

Last revised by Jeevan K Karuppannan on 17 Feb 2024

Bertolotti syndrome refers to the association between lumbosacral transitional vertebrae and low back pain.

Although it may be a consideration in younger patients, the entity is considered controversial and has been both supported and disputed. Some studies suggest lumbosacral transitional vertebrae types II and IV positively correlating with prevalence and severity of lower back pain and buttock pain 6.

Prevalence is estimated at ~5% (range 4-8%) of the population.

Lumbosacral spine radiographs are usually sufficient for identifying the skeletal abnormality, however can not definitively identify the transitional vertebrae as the source of pain. MRI is useful when radicular features with a prolapsed disc co-occur.

Some studies advocate surgical resection in selected refractory to more conservative approaches 9.

The Italian radiologist Mario Bertolotti (1876-1957) 10 was the first to describe the syndrome in 1917.

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Cases and figures

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