Bertolotti syndrome

Case contributed by Dr Abdulmajid Bawazeer


Persistent long standing left low back pain.

Patient Data

Age: 65 years
Gender: Male

There is transitional L5 vertebra with a left large transverse process which fuses with the sacrum forming a pseudo-articulation at that location. This could also be called hemi-sacralization of the L5 vertebra.

Grade 1 anterior spondylolisthesis of L4 over L5. Degenerative changes in the spine is noted.

Case Discussion

Bertolotti syndrome is common and affects 4-8% of the population with the classical presentation being chronic lower back pain.

Management includes fluoroscopically-guided steroid injection, radiofrequency ablation and surgical excision of the large transverse process.

This case is in keeping with type IIa LSTV according to Castellvi classification of lumbosacral vertebrae.

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Case information

rID: 58974
Published: 17th Mar 2018
Last edited: 12th Dec 2020
Inclusion in quiz mode: Included

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