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

Arquivos de Neuro-Psiquiatria

Daniel Benzecry De Almeida¹  Tobias Alécio Mattei¹  Marília Grando Sória¹  Mirto Nelso Prandini²  André Giacomelli Leal¹  Jerônimo Buzzeti Milano¹  Ricardo Ramina¹ 

[1] ,Instituto de Neurologia de Curitiba Department of Neurosurgery Curitiba PR ,Brazil

关键词: low back pain;    lumbosacral region;    spine;    dor lombar;    região lombossacral;    coluna vertebral;   

DOI  :  10.1590/S0004-282X2009000200018

来源: SciELO

【 摘 要 】

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.

【 授权许可】

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