Bertolotti's syndrome
Encyclopedia
Bertolotti's syndrome is a form of back pain
Back pain
Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.The pain can often be divided into neck pain, upper back pain, lower back pain or tailbone pain...

associated with lumbosacral transitional vertebrae. It can be treated surgically with posterolateral fusion or resection of the transitional articulation. Non surgical treatments include steriod 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 vertebrae
Lumbar vertebrae
The lumbar vertebrae are the largest segments of the movable part of the vertebral column, and are characterized by the absence of the foramen transversarium within the transverse process, and by the absence of facets on the sides of the body...

 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 help to detect this syndrome.
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