What is Bertolotti's syndrome?
Bertolotti's syndrome is a form of back pain associated with lumbosacral transitional vertebrae. It can be treated surgically with posterolateral fusion or resection of the transitional articulation. Non surgical treatments include steroid injections in the lower back or radiofrequency sensory ablation. It is named for Mario Bertolotti, an Italian physician
Bertolotti's syndrome is defined by a transitional 5th lumbar vertebra resulting in partial sacralization. Of importance is that this syndrome will result in a pain generating 4th lumbar disc resulting in a "sciatic" type of a pain correlating to the 5th lumbar nerve root. Usually the transitional vertebra will have a "spatulated" transverse process on one side resulting in articulation or partial articulation with the sacrum or at time the illium and in some cases with both. This results in limited / altered motion at the lumbo-sacral articulation. This loss of motion will then be compensated for at segments superior to the transitional vertebra resulting in accelerated degeneration and strain through the L4 disc level which can become symptomatic and inflame the adjacent L5 nerve root resulting in "sciatic" or radicular pain patterns. This is a congenital condition and is usually not symptomatic until one's later twenties or early thirties, yet there are cases found where Bertolotti's is symptomatic at a much earlier age. MRI may help to detect this syndrome.