Updated: Sep 16, 2019
Courtesy of Almoosa Specialist Hospital
Low back pain
CASE 7 ANSWER
The most inferior and caudal lumbar vertebra demonstrates an enlarged left transverse process that shows pseudo-articulation with the left sacral ala (yellow arrow on the frontal radiograph and the yellow circles on coronal and 3D CT reformations)
Bertolotti syndrome demonstrates anatomic variation within the most inferior caudal lumbar vertebral body with a large transverse process that forms a pseudoarthrosis or a bony fusion with the sacral ala or the iliac crest.
May lead to degenerative changes at the site of pseudoarthrosis, which could result in long-standing lower back pain.
Usually presents in patients less than 30 years old.
Can be treated by percutaneous injection of anesthetic and steroids or even radiofrequency ablation of the anomalous joint. Surgical option by osteotomy and fusion of the pseudoarthrosis is occasionally considered.