Transitional lumbosacral vertebrae and low back pain: diagnostic pitfalls and management of Bertolotti's syndrome

• Autor(a) principal: Almeida, Daniel Benzecry de
• Data de Publicação: 2009
• Outros Autores: Mattei, Tobias Alécio, Sória, Marília Grando, Prandini, Mirto Nelso [UNIFESP], Leal, André Giacomelli, Milano, Jerônimo Buzzeti, Ramina, Ricardo
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0004-282X2009000200018; http://repositorio.unifesp.br/handle/11600/5022
• topic: low back pain; lumbosacral region; spine; dor lombar; região lombossacral; coluna vertebral

OBJECTIVE: Bertolotti's syndrome is a spine disorder characterized by the occurrence of a congenital lumbar transverse mega-apophysis in a transitional vertebral body that usually articulates with the sacrum or the iliac bone. It has been considered a possible cause of low back pain. METHOD: We analyzed the cases of Bertolotti's syndrome that failed clinical treatment and reviewed the literature concerning this subject. RESULTS: Five patients in our series had severe low back pain due to the neo-articulation and two of them were successfully submitted to surgical resection of the transverse mega-apophysis. Taking into account the clinical and surgical experience acquired with these cases, we propose a diagnostic-therapeutic algorithm. CONCLUSION: There is still no consensus about the most appropriate therapy for Bertolotti's syndrome. In patients in whom the mega-apophysis itself may be the source of back pain, surgical resection may be a safe and effective procedure.