Bertolotti Syndrome

UNDERSTANDING THE SYMPTOMS, CAUSES AND TREATMENTS

Unique Care for a Unique Condition.

Welcome to VSI, where we specialize in providing solutions and support for patients with Bertolotti Syndrome who have struggled for years to find relief. Our world-renowned experts are dedicated to offering effective care, making VSI a unique destination for those seeking comprehensive solutions. At VSI, we pride ourselves on offering non-surgical options not available elsewhere and advanced surgical treatments using modern technology to ensure faster recovery times. We understand that many of our patients have gone misdiagnosed or undiagnosed for years, enduring persistent discomfort and uncertainty. By specializing in non-surgical and surgical treatments, our experts work closely with you to develop a personalized care plan that best suits your needs.
As a premier destination for Bertolotti Syndrome care, we make the process seamless for our fly-in patients by seamlessly coordinating all aspects of their care and assisting with travel recommendations. We make it as easy for you to access the care you need to resume your life.

We are here to support you on your journey to recovery, offering both virtual and in-person consultations to get you started on the path to feeling better – call today to get started: 703.709.1114.

What is Bertolotti Syndrome?

Bertolotti syndrome, also known as lumbosacral transitional vertebra (LSTV), is a congenital disorder that often manifests as chronic back pain along the waistline. It occurs when the transverse process(es) of the fifth lumbar vertebra articulates with the sacrum, resulting in abnormal spinal mobility and associated discomfort. This condition is characterized by an irregular vertebral structure and can be a source of ongoing pain and discomfort for affected individuals. Often confused with sacroiliitis, this diagnosis affects less than 10% of the population and because of this it often goes undiagnosed. Bertolotti’s syndrome is a rare cause of back pain and can be treated by a qualified spinal specialist with modern spinal healthcare.

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Symptoms of Bertolotti Syndrome

Patients diagnosed with Bertolotti Syndrome, or the transitional vertebra, often do not experience any symptoms. However, the patients that do, typically experience lower back pain that radiates from the sides of their waistline. The pain may be confused with sacroiliac (SI) joint pain, lumbar disc, or lumbar facet joint pain. This is why the condition is often misdiagnosed.

A proper evaluation by a seasoned spine expert is critical for the accurate diagnosis of Bertolotti Syndrome. Finding a spine surgeon who offers not only surgical solutions but also non-surgical treatment plans is beneficial for patients seeking a conservative approach.

When to Seek Treatment for Bertolotti Syndrome

If you’re noticing symptoms associated with Bertolotti Syndrome and suspect a spinal issue, it’s crucial to consider consulting a board-certified spinal specialist. Reach out promptly to a board-certified spine surgeon for an accurate diagnosis and timely treatment. Early intervention can significantly improve your overall well-being and provide a broader range of treatment options, which may decrease as symptoms persist. The key to a successful and speedy recovery lies in addressing the root of the pain with your spine specialist as soon as symptoms arise.

It’s important to note that these are general guidelines based on our expertise in spine care over the past three decades, recognizing that each patient’s symptoms may be unique.

Common Causes of Bertolotti Syndrome

During our natural spinal development, vertebrae located in the sacral region fuse together to form one bone called the sacrum. The sacrum is located in the region of the pelvis. In the lower back or lumbar spine, lumbar vertebral bodies develop as separate segments with their own discs, transverse processes, and spinous processes. Having these separate vertebral bodies allows for motion in our lumbar spine.

However, in the developmental stages, before birth, some patients’ lowest lumbar vertebra (called the L5 lumbar vertebra) could not quite decide whether to be part of the sacrum, or not; it is considered a transitional vertebra. A transitional vertebrae transverse process is typically enlarged and often looks like a fake joint that touches the pelvis. This fake joint between this enlarged transverse process and the sacrum, if inflamed, can cause low back pain and discomfort. This low back pain is often very similar to pain related to sacroiliac pain or even lumbar facet pain, which is why patients can be frustrated by misdiagnosis if not properly evaluated by a Bertolotti Syndrome expert.

Diagnosing Bertolotti Syndrome

Due to the unique nature of Bertolotti Syndrome, it is often misdiagnosed. For this reason, it is important to select a board-certified Bertolotti specialist who can accurately rule out the other causes of back pain including pain related to the lumbar disc, pain related to the lumbar facet joints, and degenerative disc disease, and even pain related to the sacroiliac joint. During your initial consultation, you will undergo a thorough health history and comprehensive physical exam. Your spine specialist may require specific diagnostic imaging or other diagnostics to rule out these other pain generators and locate the source of pain or dysfunction.

Treatment for Bertolotti Syndrome is not a one-size-fits-all solution and it begins with the diagnosis process. We will then work with you to craft a customized treatment plan that is as unique as you are!

Spine-specialized physical therapy to relieve back pain

Treatment Solutions for Bertolotti Syndrome

At VSI we prioritize personalized, non-surgical treatments as our initial approach. Our specialized spine physical therapy focuses on mobilization, core strengthening, and stretching to alleviate symptoms. We also offer outpatient regenerative medicine treatments, including stem cell therapy and platelet-rich plasma (PRP). These innovative therapies harness the body’s natural healing capabilities, offering safe, outpatient options with quicker recovery times than surgery.

However, for some patients, surgical intervention becomes necessary. Our minimally invasive spine surgery can effectively reshape the enlarged transverse process, removing the problematic transitional joint and providing significant relief. Alternatively, we offer minimally invasive spinal fusion to stabilize the affected area. Both surgical options are designed to minimize recovery time and maximize patient outcomes, ensuring tailored care for each individual’s unique needs.

Frequently Asked Questions about Bertolotti Syndrome

Steroid injections can help provide longer-lasting pain relief than medications. The pain people experience from Bertolotti’s Syndrome is due to the transverse process of the transitional vertebrae rubbing against the pelvis bone. Repetitive rubbing from daily activities can cause irritation and inflammation leading to pain. This is similar to arthritis in your joints. As your bones keep rubbing on each other, they become irritated, inflamed, and painful. The administered steroid injection calms down the inflammation and as a result, provides pain relief.

Bertolotti’s Syndrome does not cause “sciatic” pain. However, Bertolott Syndrome can cause premature degeneration of the discs and vertebrae in your lumbar spine which may cause disc degeneration, disc herniation, or nerve irritation.

Most patients with Bertolotti’s Syndrome can live their life without any problems. Leaving symptomatic Bertolotti Syndrome untreated may cause worsening pain, impact on daily activities, and premature degeneration of the lumbar spine. Over time, this also may lead to other complications in your spine such as disc herniations, spondylosis, and radiculopathy. The sooner you have this evaluated likely the more treatment options will be available to you.

X-rays of your lower back/pelvis are the most common imaging technique used to identify Bertolotti Syndrome. When looking at the X-rays, our spine team is looking for an enlarged transverse process on the transitional vertebrae (usually L5, the lowest lumbar vertebrae). Sometimes if the X-rays are not clear enough, we may order a CT scan of your lower back/pelvis to better assess the bony anatomy and to rule out any other pathologies that may be contributing to the pain such as sacroiliitis.