Abstract
BackgroundBertolotti’s syndrome is widely known to cause low back pain in young patients and must be considered as a differential diagnosis. Its treatment such as conservative therapy or surgery remains controversial. Surgical procedure is recommended for intractable low back pain. The three-dimensional (3D) lumbosacral transitional vertebrae anatomy should be completely understood for a successful surgery. Using an intraoperative 3D navigation and preoperative preliminary surgical planning with a patient-specific 3D plaster model contribute for safe surgery and good outcome.Case presentationA case of a 22-year-old Japanese male patient with intractable left low back pain due to lumbosacral transitional vertebrae with Bertolotti’s syndrome. The symptom resisted the conservative treatment, and anesthetic injection at pseudoarticulation only provided a short-term pain relief. Posterior resection using intraoperative three-dimensional (3D) navigation has been performed through microendoscopic view. Pseudoarticulation was totally and successfully resected in a safe manner.ConclusionsPreoperative surgical planning and rehearsal using a patient-specific 3D plaster model was greatly useful and effective for surgeons in performing accurate and safe pseudoarticulation resection.
Highlights
IntroductionBertolotti’s syndrome is characterized by congenital lumbosacral transitional vertebrae (LSTV) most commonly occurring at L5 level and by enlarged transverse process
Bertolotti’s syndrome is characterized by congenital lumbosacral transitional vertebrae (LSTV) most commonly occurring at L5 level and by enlarged transverse processIt is typically treated with conservative therapy, such as medication, trigger point anesthetic injection, and rehabilitation
*Correspondence: joker1011ks@yahoo.co.jp Department of Orthopaedic Surgery, Okayama Medical Center, National Hospital Organization, 1711‐1 Tamasu, Kitaku, Okayama city, Okayama, Japan of L5 articulates or unilateral or bilateral unions with the sacral area [1]. This syndrome has been reported to result in low back pain in young patients [2]
Summary
Bertolotti’s syndrome is characterized by congenital lumbosacral transitional vertebrae (LSTV) most commonly occurring at L5 level and by enlarged transverse process. It is typically treated with conservative therapy, such as medication, trigger point anesthetic injection, and rehabilitation. Bertolotti’s syndrome is widely known to cause low back pain in young patients and must be considered as a differential diagnosis. Its treatment such as conservative therapy or surgery remains controversial. Using an intraoperative 3D navigation and preoperative preliminary surgical planning with a patient-specific 3D plaster model contribute for safe surgery and good outcome. Pseudoarticulation was totally and successfully resected in a safe manner
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