Bertolotti syndrome is something has not been heard of when it comes to lower back pain, but diagnostic work has uncovered a common congenital condition. Back pain is experienced at some point by all of us. Around two-thirds of the population will develop low back pain in their life, and more than half will develop chronic low back pain or pain that has lasted more than six months. Low back pain can be challenging in finding the root cause. Diagnostic work is required through X-rays and MRIs. These tests can identify a lesser-known cause of mechanical low back pain called Bertolotti syndrome.
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This congenital condition’s name comes from Italian physician Mario Bertolotti. It is in 10 to 20 percent of the population, —with or with no lower back pain. Bertolotti syndrome happens when the last lumbar vertebra, known as the lumbosacral transitional vertebra/LSTV. This vertebra and the sacrum become fused together or create a false joint due to an enlarged transverse process.
This can be bony bumps on the vertebrae where muscles and ligaments attach to the lumbosacral transitional vertebra. When the LSTV and sacrum fuse together, known as sacralization or pseudo-joint, it does not generate pain. It’s just the way that an individual’s anatomy has been since birth. Only when it causes lower back pain that it is called Bertolotti syndrome.
Low back pain that leads to inflammation and reactive muscle spasms brought on from Bertolotti syndrome can be caused by:
Most individuals usually never know they have a sacralization or pseudo-joint. These are often found accidentally from an X-ray for something unrelated. But when symptoms present they can vary from person to person and usually appear in adulthood—in the 20s or 30s.
Bertolotti syndrome can be diagnosed based on medical history, physical exam, and X-rays. A physical exam can include a recreation of the movement/s that triggered the pain/discomfort. An X-ray of the low back and pelvis will reveal any bony abnormalities.
Bertolotti syndrome can be effectively managed with non-invasive treatments. These include:
If you or someone you know is dealing with some form of idiopathic low back pain and doctors can’t seem to pinpoint the cause. Bertolotti syndrome could be a suspect, therefore it’s best to seek a spine specialist near you that can help.
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