Weerakkody Y, K Karuppannan J, Chieng R, et al. Bertolotti syndrome. Reference article, Radiopaedia.org (Accessed on 06 May 2024) https://doi.org/10.53347/rID-24873
Although it may be a consideration in younger patients, the entity is considered controversial and has been both supported and disputed. Some studies suggest lumbosacral transitional vertebrae types II and IV positively correlating with prevalence and severity of lower back pain and buttock pain 6.
Prevalence is estimated at ~5% (range 4-8%) of the population.
Radiographic features
Lumbosacral spine radiographs are usually sufficient for identifying the skeletal abnormality, however can not definitively identify the transitional vertebrae as the source of pain. MRI is useful when radicular features with a prolapsed disc co-occur.
Treatment and prognosis
Some studies advocate surgical resection in selected refractory to more conservative approaches 9.
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History and etymology
The Italian radiologist MarioBertolotti (1876-1957) 10 was the first to describe the syndrome in 1917.
2. Quinlan JF, Duke D, Eustace S. Bertolotti's syndrome. A cause of back pain in young people. J Bone Joint Surg Br. 2006;88 (9): 1183-6. doi:10.1302/0301-620X.88B9.17211 - Pubmed citation
4. Paraskevas G, Tzaveas A, Koutras G et-al. Lumbosacral transitional vertebra causing Bertolotti's syndrome: a case report and review of the literature. Cases J. 2009;2 (1): 8320. doi:10.4076/1757-1626-2-8320 - Free text at pubmed - Pubmed citation
8. Li Y, Lubelski D, Abdullah KG et-al. Minimally invasive tubular resection of the anomalous transverse process in patients with Bertolotti's syndrome: presented at the 2013 Joint Spine Section Meeting: clinical article. J Neurosurg Spine. 2014;20 (3): 283-90. doi:10.3171/2013.11.SPINE13132 - Pubmed citation
9. Jancuska JM, Spivak JM, Bendo JA. A Review of Symptomatic Lumbosacral Transitional Vertebrae: Bertolotti's Syndrome. Int J Spine Surg. 2015;9: 42. doi:10.14444/2042 - Free text at pubmed - Pubmed citation
10. LUPO M. [Prof. Mario Bertolotti]. (1958) Minerva medica. 49 (37): Varia, 840-6. Pubmed