Minimally invasive surgical treatment of Bertolotti's Syndrome

case report.

Kene T. Ugokwe, Tsu Lee Chen, Eric Otto Klineberg, Michael P. Steinmetz

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

OBJECTIVE: This article aims to provide more insight into the presentation, diagnosis, and treatment of Bertolotti's syndrome, which is a rare spinal disorder that is very difficult to recognize and diagnose correctly. The syndrome was first described by Bertolotti in 1917 and affects approximately 4 to 8% of the population. It is characterized by an enlarged transverse process at the most caudal lumbar vertebra with a pseudoarticulation of the transverse process and the sacral ala. It tends to present with low back pain and may be confused with facet and sacroiliac joint disease. METHODS: In this case report, we describe a 40-year-old man who presented with low back pain and was eventually diagnosed with Bertolotti's syndrome. The correct diagnosis was made based on imaging studies which included computed tomographic scans, plain x-rays, and magnetic resonance imaging scans. The patient experienced temporary relief when the abnormal pseudoarticulation was injected with a cocktail consisting of lidocaine and steroids. In order to minimize the trauma associated with surgical treatment, a minimally invasive approach was chosen to resect the anomalous transverse process with the accompanying pseudoarticulation. RESULTS: The patient did well postoperatively and had 97% resolution of his pain at 6 months after surgery. CONCLUSION: As with conventional surgical approaches, a complete knowledge of anatomy is required for minimally invasive spine surgery. This case is an example of the expanding utility of minimally invasive approaches in treating spinal disorders.

Original languageEnglish (US)
JournalNeurosurgery
Volume62
Issue number5 Suppl 2
StatePublished - May 2008
Externally publishedYes

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Low Back Pain
Zygapophyseal Joint
Sacroiliac Joint
Lumbar Vertebrae
Minimally Invasive Surgical Procedures
Joint Diseases
Lidocaine
Anatomy
Spine
Therapeutics
Steroids
Magnetic Resonance Imaging
X-Rays
Pain
Wounds and Injuries
Population

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Ugokwe, K. T., Chen, T. L., Klineberg, E. O., & Steinmetz, M. P. (2008). Minimally invasive surgical treatment of Bertolotti's Syndrome: case report. Neurosurgery, 62(5 Suppl 2).

Minimally invasive surgical treatment of Bertolotti's Syndrome : case report. / Ugokwe, Kene T.; Chen, Tsu Lee; Klineberg, Eric Otto; Steinmetz, Michael P.

In: Neurosurgery, Vol. 62, No. 5 Suppl 2, 05.2008.

Research output: Contribution to journalArticle

Ugokwe, KT, Chen, TL, Klineberg, EO & Steinmetz, MP 2008, 'Minimally invasive surgical treatment of Bertolotti's Syndrome: case report.', Neurosurgery, vol. 62, no. 5 Suppl 2.
Ugokwe, Kene T. ; Chen, Tsu Lee ; Klineberg, Eric Otto ; Steinmetz, Michael P. / Minimally invasive surgical treatment of Bertolotti's Syndrome : case report. In: Neurosurgery. 2008 ; Vol. 62, No. 5 Suppl 2.
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