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 since the Italian radiologist Mario Bertolotti (1876-1957) 10 first described it in 1917. 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 approximately 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.
Treatment and prognosis
Some studies advocate surgical resection in selected refractory to more conservative approaches 9.
- 1. Konin GP, Walz DM. Lumbosacral transitional vertebrae: classification, imaging findings, and clinical relevance. AJNR Am J Neuroradiol. 2010;31 (10): 1778-86. AJNR Am J Neuroradiol (full text) - doi:10.3174/ajnr.A2036 - Pubmed citation
- 2. Quinlan JF, Duke D, Eustace S. Bertolotti's syndrome. A cause of back pain in young people. J Bone Joint Surg Br. 2006;88 (9): 1183-6. doi:10.1302/0301-620X.88B9.17211 - Pubmed citation
- 3. Mitra R, Carlisle M. Bertolotti's syndrome: a case report. Pain Pract. 2009;9 (2): 152-4. doi:10.1111/j.1533-2500.2008.00253.x - Pubmed citation
- 4. Paraskevas G, Tzaveas A, Koutras G et-al. Lumbosacral transitional vertebra causing Bertolotti's syndrome: a case report and review of the literature. Cases J. 2009;2 (1): 8320. doi:10.4076/1757-1626-2-8320 - Free text at pubmed - Pubmed citation
- 5. Jain A, Agarwal A, Jain S et-al. Bertolotti syndrome: a diagnostic and management dilemma for pain physicians. Korean J Pain. 2013;26 (4): 368-73. doi:10.3344/kjp.2013.26.4.368 - Free text at pubmed - Pubmed citation
- 6. Nardo L, Alizai H, Virayavanich W et-al. Lumbosacral transitional vertebrae: association with low back pain. Radiology. 2012;265 (2): 497-503. Radiology (full text) - doi:10.1148/radiol.12112747 - Free text at pubmed - Pubmed citation
- 7. Mitra R, Carlisle M. Bertolotti's syndrome: a case report. Pain Pract. 2009;9 (2): 152-4. doi:10.1111/j.1533-2500.2008.00253.x - Pubmed citation
- 8. Li Y, Lubelski D, Abdullah KG et-al. Minimally invasive tubular resection of the anomalous transverse process in patients with Bertolotti's syndrome: presented at the 2013 Joint Spine Section Meeting: clinical article. J Neurosurg Spine. 2014;20 (3): 283-90. doi:10.3171/2013.11.SPINE13132 - Pubmed citation
- 9. Jancuska JM, Spivak JM, Bendo JA. A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti's Syndrome. Int J Spine Surg. 2015;9: 42. doi:10.14444/2042 - Free text at pubmed - Pubmed citation
- 10. LUPO M. [Prof. Mario Bertolotti]. (1958) Minerva medica. 49 (37): Varia, 840-6. Pubmed
Promoted articles (advertising)
Unable to process the form. Check for errors and try again.