Bertolotti syndrome (BS) is a uncommon clinical condition, characterized by the presence of a
lumbosacral transitional vertebra (LSTV) that may contribute to lower back pain.
Often underdiagnosed condition characterized by the presence of a lumbarization of the sacral vertebra
or a pseudoarthrosis between the transverse process of the lower lumbar vertebra and the sacrum.
The condition is associated with altered biomechanics, result from abnormal development of the
lumbosacral junction, leading to mechanical stress, nerve root compression, or musculoskeletal
dysfunction. It typically presents as low back pain, often with associated sciatica or radicular symptoms.
While BS remains under-recognized, its diagnosis is essential in patients with chronic low back pain
unresponsive to conventional treatments.
Diagnosis is primarily radiographic, with X-rays, CT scans, and MRIs are critical for identifying LSTV
and ruling out other spinal pathologies.
Management strategies for Bertolotti syndrome include conservative treatments such as physical
therapy, analgesics, and anti-inflammatory medications, as well as surgical options in severe cases or
refractory cases.
Awareness of Bertolotti syndrome is essential for clinicians, as its presentation can overlap with
more common lumbar pathologies, making accurate diagnosis and appropriate treatment critical for
improving patient outcomes.
This syndrome is important to consider in the differential diagnosis of lower back pain to ensure
appropriate management and improve patient outcomes.
