Bertolotti's syndrome

Bertolotti's syndrome

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Bertolotti's syndrome is a form of lumbago in the lumbosacral transitional vertebrae. The syndrome is not usually treated, as not much is known yet about these spinal segments.

Etymology

It is named after Mario Bertolotti, an Italian physician

Pathophysiology

Bertolotti's syndrome is defined by a transitional 5th lumbar vertebra resulting in partial sacralization. Of importance is that this syndrome will result in a pain generating 4th lumbar disc resulting in a "sciatic" type of a pain correlating to the 5th lumbar nerve root.

Usually the transitional vertebra will have a "spatulated" transverse process on one side resulting in articulation or partial articulation with the sacrum or at time the ilium and in some cases with both. This results in limited / altered motion at the lumbo-sacral articulation. This loss of motion will then be compensated for at segments superior to the transitional vertebra resulting in accelerated degeneration and strain through the L4 disc level which can become symptomatic and inflame the adjacent L5 nerve root resulting in "sciatic" or radicular pain patterns. This is a congenital condition and is usually not symptomatic until one's later twenties or early thirties, yet there are cases found where Bertolotti's is symptomatic at a much earlier age.

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