Bertolotti's Syndrome: Sacralization of L5 and lumbar pain, case report

Síndrome de Bertolotti: Sacralización de L5 y dolor lumbar, reporte de caso

Authors

  • Carlos Alfredo Iñiguez-Guzmán Universidad Católica de Cuenca. Cuenca, Ecuador.
  • Diego Morales-Jimenez Universidad Católica de Cuenca. Cuenca, Ecuador.
  • Emilio José Iñiguez-Peña Universidad Católica de Cuenca. Cuenca, Ecuador.
  • Etsa Robinson Tsenkush-Chamik Universidad Católica de Cuenca. Cuenca, Ecuador.

DOI:

https://doi.org/10.22258/hgh.2023.72.150

Abstract

Bertolotti syndrome is defined as low back pain with or without radicular pain, associated with congenital anomaly in the vertebral morphology (transverse megapophyses with or without fusion with sacral wings or iliac crests), as a consequence of which osteodegenerative facet and disc changes are observed at levels above the transitional vertebra, although it can also manifest itself at the same level with extraforaminal compressive disc pathology. With the aim of presenting a case from the radiological point of view of sacralization of L5 associated with low back pain, we present a patient who presents low back pain for 3 months; it is exacerbated with flexor-extensor and rotational movements of the trunk, he suffers a fall from his own height so an anteroposterior (AP) study of the pelvis and lateral sacro-coccyx is requested where findings related to Bertolotti's Syndrome are observed. This syndrome should be considered in the differential diagnosis of patients with low back pain with or without radiculopathy. Keys words: Low Back Pain; Bertolotti´s syndrome; Technology, Radiologic.  

Downloads

Download data is not yet available.

Author Biographies

Carlos Alfredo Iñiguez-Guzmán, Universidad Católica de Cuenca. Cuenca, Ecuador.

Universidad Católica de Cuenca. Cuenca, Ecuador. Médico, Especialista en Imagenología.

Diego Morales-Jimenez , Universidad Católica de Cuenca. Cuenca, Ecuador.

Universidad Católica de Cuenca. Cuenca, Ecuador. Estudiante de Medicina.

Emilio José Iñiguez-Peña, Universidad Católica de Cuenca. Cuenca, Ecuador.

Universidad Católica de Cuenca. Cuenca, Ecuador. Estudiante de Medicina.

Etsa Robinson Tsenkush-Chamik, Universidad Católica de Cuenca. Cuenca, Ecuador.

Universidad Católica de Cuenca. Cuenca, Ecuador. Estudiante de Medicina.  

References

Tatara Y, Niimura T, Sekiya T, Mihara H. Changes in Lumbosacral Anatomy and Vertebral Numbering in Patients with Thoracolumbar and/or Lumbosacral Transitional Vertebrae. JB JS Open Access. 2021 Jul 14;6(3):e20.00167. doi: 10.2106/JBJS.OA.20.00167. .

Becker L, Taheri N, Haffer H, Muellner M, Hipfl C, Ziegeler K, Diekhoff T, Pumberger M. Lumbosacral Transitional Vertebrae Influence on Acetabular Orientation and Pelvic Tilt. J Clin Med. 2022 Aug 31;11(17):5153. doi: 10.3390/jcm11175153.

Hou L, Bai X, Li H, Cheng S, Wen T, He Q, et al. “acquired” type Castellvi-IIIa lumbarization transformed from Castellvi-IIa following discectomy and fusion at lumbosacral level: A case report. Spine (Phila Pa 1976). 2018;43:E1364–7. doi: 10.1097/brs.0000000000002711.

Hanhivaara J, Määttä JH, Niinimäki J, Nevalainen MT. Lumbosacral transitional vertebrae are associated with lumbar degeneration: retrospective evaluation of 3855 consecutive abdominal CT scans. Eur Radiol. 2020 Jun;30(6):3409-3416. doi: 10.1007/s00330-020-06691-2.

Moreno García Marina Soledad, del Río-Martínez Pilar S., Baltanás Rubio Pablo, Cía Blasco Pedro. Síndrome de Bertolotti: a propósito de un caso. Rev.Colomb.Reumatol. septiembre de 2016; 23(3): 200-203. https://doi.org/10.1016/j.rcreu.2015.12.007 .

Kapetanakis S, Chaniotakis C, Paraskevopoulos C, Pavlidis P. An unusual case report of Bertolotti’s syndrome: Extraforaminal stenosis and L5 unilateral root compression (Castellvi Type III an LSTV). J Orthop Case Rep. 2017;7(3):9–12. doi: 10.13107/jocr.2250-0685.782.

McGrath K, Schmidt E, Rabah N, Abubakr M, Steinmetz M. Clinical assessment and management of Bertolotti Syndrome: a review of the literature. Spine J. 2021;21(8):1286–96. doi: 10.1016/j.spinee.2021.02.023.

Aamir S, Imtiaz H, Rehman Z, Ambreen S, Ghani F, Naoureen A. Lumbosacral Transitional Vertebrae in patients visiting tertiary care hospital of Khyber pakhtukhwa: A radiological study. J Ayub Med Coll Abbottabad. 2020;32(2):234–723.

Dar G, Peled N. The association between sacralization and spondylolisthesis. Anat Sci Int. 2014;89(3):156–60. doi: 10.1007/s12565-013-0213-y.

Adams R, Herrera-Nicol S, Jenkins A III. Surgical treatment of a rare presentation of Bertolotti’s syndrome from Castellvi type IV lumbosacral transitional vertebra: Case report and review of the literature. J Neurol Surg Rep. 2018;79 (3):e70–e74. doi: 10.1055/s-0038-1667172.

Bolla SR. Partial Lumbosacral Transitional Vertebra: A case of unilateral sacralization and its embryological and clinical implications. Kathmandu Univ Med J (KUMJ). 2019;17(67):245–247.

Muir JM. Chiropractic management of a patient with low back pain and Castellvi type II lumbosacral transitional vertebrae. J Chiropr Med 2012;11(4):254–9. doi: 10.1016/j.jcm.2012.02.005.

Murtagh R, Castellvi AE. Motion preservation surgery in the spine. Neuroimaging Clin N Am. 2014;24(2):287–94. DOI: 10.1016/j.nic.2014.01.008.

Mikula AL, Lakomkin N, Ransom RC, Flanigan PM, Waksdahl LA, Pennington Z, et al. Operative treatment of Bertolotti syndrome: Resection versus fusion. World Neurosurg, 2022;165:e311–6. doi: 10.1016/j.wneu.2022.06.042.

Alinda NO, Mugarura R, Malagala J, Kisembo H. Prevalence, patterns, functional disability of Bertolotti syndrome among patients with low back pain at Mulago National Referral Hospital. Afr Health Sci. 2022;22(4):168–77. doi: 10.4314/ahs.v22i4.20.

Published

2023-12-20

How to Cite

Iñiguez-Guzmán, C. A., Morales-Jimenez , D., Iñiguez-Peña, E. J., & Tsenkush-Chamik, E. R. (2023). Bertolotti’s Syndrome: Sacralization of L5 and lumbar pain, case report: Síndrome de Bertolotti: Sacralización de L5 y dolor lumbar, reporte de caso. Peruvian Journal of Health Care and Global Health, 7(2). https://doi.org/10.22258/hgh.2023.72.150

Issue

Section

Case reports

Most read articles by the same author(s)