Partial lumbosacral transitional vertebra resection for contralateral facetogenic pain

Jeffrey S. Brault, Jay Smith, Bradford L. Currier

Research output: Contribution to journalArticle

45 Scopus citations

Abstract

Study Design. Case report of surgically treated mechanical low back pain from the facet joint contralateral to a unilateral anomalous lumbosacral articulation (Bertolotti's syndrome). Objectives. To describe the clinical presentation, diagnostic evaluation, and management of facet-related low back pain in a 17-year-old cheerleader and its successful surgical treatment with resection of a contralateral anomalous articulation. Summary of Background Data. Lumbosacral transitional vertebrae are common in the general population. Bertolotti's syndrome is mechanical low back pain associated with these transitional segments. Little is known about the pathophysiology and mechanics of these vertebral segments and their propensity to be pain generators. Treatment of this syndrome is controversial, and surgical intervention has been infrequently reported. Method. A retrospective chart analysis and radiographic review were performed. Results. Repeated fluoroscopically guided injections implicated a symptomatic L6-S1 facet joint contralateral to an anomalous lumbosacral articulation. Eventually, a successful surgical outcome was achieved with resection of the anomalous articulation. Conclusion. Clinicians should consider the possibility that mechanical low back pain may occur from a facet contralateral to a unilateral anomalous lumbosacral articulation, even in a young patient. Although reports of surgical treatment of Bertolotti's syndrome are infrequent, resection of the anomalous articulation provided excellent results in this patient, presumably because of reduced stresses on the symptomatic facet.

Original languageEnglish (US)
Pages (from-to)226-229
Number of pages4
JournalSpine
Volume26
Issue number2
DOIs
StatePublished - Jan 15 2001

Keywords

  • Anomalous lumbosacral junction
  • Resection
  • Transitional vertebra
  • Transverse process abnormalities

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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