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Back to Health: Bertolotti’s Syndrome

Back to Health: Bertolotti’s Syndrome

Back to Health: Bertolotti’s Syndrome

What is it?

Bertolotti’s Syndrome is a congenital spine defect (something you are born with) that occurs between the L5 vertebra and the sacrum (tailbone).  The defect can come in various categories of defect and can be unilateral or bilateral.  The end result is extra bone between the lowest movement segment of the lower back that can result in a painful situation. 

What is the cause?

It is a congenital cause as a result of genetics and the way your bones form early in life.  It occurs to the lumbosacral region and is also called a lumbosacral transitional vertebra.  It involves an enlarged and misshapen transverse process that can develop a pseudoarthrosis (fake joint) with the sacrum.  This extra bone can be a real pain in the side.

What symptoms are associated with it?

The classic presentation is a chronic one-sided pain that radiates into the lower back and side.  Pain is exacerbated with positional changes and is increased with extension and same sided lateral flexion.  Pain is usually reduced with laying down, bending forward.

How is it diagnosed?

Diagnosis can be made with x-ray evaluation.  In the Castellvi Lumbosacral Transitional Vertebra classification, a type I involves an enlarged transverse process either unilaterally (Ia) or bilaterally (Ib).  A type 2 involves a pseudoarthrosis either unilaterally (IIa) or bilaterally (IIb).  A type 3 involves a fused transverse process to the sacrum, again ununilaterally (IIIa) or bilaterally (IIIb).  Lastly, a type IV Lumbosacral transition segment would involve a one-sided pseudoarthrosis with the other side being fused.  

Is there a treatment for Bertollotti’s Syndrome?  

Most of the patients I have seen with this condition have a mild pain that is tolerable, yet annoying.  Aside from avoiding movements that would increase pressure on the transition segment (bending backward or toward the side of the segment), surgical resection of the abnormality is the only option for long-term relief of the condition.  

Dr. Custer is the owner/operator of Better Care Chiropractic & Physical Therapy.  He is a doctor of chiropractic as well as a certified Athletic Trainer.  He works in conjunction with a physical therapist to combine chiropractic manipulation with active rehabilitative techniques to restore pain-free living. If you have questions/comments/suggestions, please feel free to contact Dr. Custer at [email protected]

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