A case of Bertolotti’s syndrome as a cause of sciatica

November 11, 2021

Case Reports

doi: 10.25259/SNI_756_2021.

eCollection 2021.

Affiliations

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Case Reports

Sarah Kawtharani et al.

Surg Neurol Int.

2021.

Abstract

Background:

Bertolotti’s syndrome (i.e., varying extent of fusion between the last lumbar vertebra and the first sacral segment) or lumbosacral transitional vertebrae is a rare cause of back pain. Notably, this syndrome is one of the differential diagnoses for patients with refractory back pain/sciatica.

Case description:

A 71-year-old male presented with low back pain of 3 years duration that radiated into the right lower extremity resulting in numbness in the L5 distribution. He then underwent a minimally invasive approach to resect the L5 “wide” transverse process following the CT diagnosis of Bertolotti’s syndrome. Prior to surgery, patient reported pain that was exacerbated by ambulation that resolved post-operative.

Conclusion:

Bertolotti’s syndrome is one of the rare causes of sciatica that often goes undiagnosed. Nevertheless, it should be ruled out for patients with back pain without disc herniations or other focal pathology diagnosed on lumbar MR scans.

Keywords:

Anatomical variation; Back pain; Bertolotti’s syndrome; Spinal anomaly; Transitional vertebrae.

Conflict of interest statement

There are no conflicts of interest.

Figures

**Figure 1:**

(a and b) Axial and coronal CT lumbosacral spine showing the l5 wide transverse process with a bony ridge connecting the l5 to the sacrum. (Red arrow).

**Figure 2:**

3D reconstruction of the lumbosacral spine showing the l5 wide transverse process with a bony ridge connecting the l5 to the sacrum. (Red circle).

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