Bertolotti syndrome

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.

Epidemiology

Prevalence is estimated at approximately 4-8% of the population.

Radiographic features

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.

See also

• Castellvi classification of lumbosacral transitional vertebrae