The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Skryabin E.G.

Tyumen State Medical University

Kicherova O.A.

Tyumen State Medical University

Zotov P.B.

Tyumen State Medical University

Main clinical characteristics of pain in patients with lumbosacral transitional vertebrae

Authors:

Skryabin E.G., Kicherova O.A., Zotov P.B.

More about the authors

Read: 1912 times


To cite this article:

Skryabin EG, Kicherova OA, Zotov PB. Main clinical characteristics of pain in patients with lumbosacral transitional vertebrae. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(5):7‑13. (In Russ.)
https://doi.org/10.17116/jnevro20241240517

Recommended articles:
Biofeedback in complex therapy of pain syndromes. Russian Journal of Pain. 2025;(2):70-75

References:

  1. Stein E, Panjeton GD, Kumar S. Endoscopic resection of Pseudoarticulation as a Treatment for Bertolotti′s Syndrome. Cureus. 2023;15910:33397. https://doi.org/10.7759/cureus.33397
  2. Skryabin EG. Local injection therapy for pain syndrome in patients with lumbosacral transitional vertebrae. Rossijskij Zhurnal Boli. 2023;21(2):66-71. (In Russ.). https://doi.org/10.17116/pain20232102166
  3. Kapoor K, Shukla A. Lumbosacral transitional vertebrae: prevalence and association with low backache. Med Res Chronicles. 2022;9(1):38-44. 
  4. Ashour A, Hassan A, Aly M, et al. Prevalence of Bertolotti′s Syndrome in Lumbosacral Surgery Procedures. Cureus. 2022;14(6):26341. https://doi.org/10.7759/cureus.26341
  5. Vaidya R, Bhatia M. Lumbosacral transitional vertebra in military aviation candidates: A cross-section study. Indian J Aerosp Med. 2021;65(1):29-32.  https://doi.org/10.25259/IJASM_50_2020
  6. Castellvi AE, Goldstein LA, Chan DP. Lumbosacral transitional vertebrae and their relationship with lumbar V extradural defects. Spine. 1984;9:493-495.  https://doi.org/10.1097/00007632-198407000-00014
  7. Marx VO. Orthopedic Diagnostics. Minsk: Science and Technology; 1978. (In Russ.).
  8. Prasad TB, Sahini SC, Srivathsav TK. Case report of lumbosacral transitional vertebra (Bertolotti’s syndrome). J Evolution Med Dent Sci. 2019;8(19):1595-1597. https://doi.org/10.14260/jemds/2019/353
  9. Fortin JD, Falco FJ. The Fortin finger test: an indicator of sacroiliac pain. Am J Orthop (Belle Mead, NJ). 1997;26(7):477-480. 
  10. Levin SM. The Fortin finger test. Am J Orthop. 1998;27(1):20. 
  11. Achta AF, Hamdaoui O, Banao M, et al. Imaging of Bertolotti Syndrome. EAS J Radiol Imaging Technol. 2022;4(6):139-142.  https://doi.org/10.36349/easjrit.2022.v04i06.005
  12. De Almeida DB, Mattei TA, Soria MG, et al. Transitional lumbosacral vertebrae and low back pain: diagnostic and management of Bertolotti’s syndrome. Arq Neuropsiquatr. 2009;67(2a):268-272.  https://doi.org/10.1590/s0004-282x2009000200018
  13. Shamburov DA. Ishias. M.: Medgis; 1954. (In Russ.).
  14. Murakami E, Aizawa T, Noguchi K, et al. Diagram specific to sacroiliac joint pain site indicated by one-finger test. J Orthop Sci. 2008;13(6):492-497.  https://doi.org/10.1007/s00776-008-1280-0
  15. Werner CML, Hoch A, Gautier L, et al. Distraction test of the posterior superior iliac spine (PSIS) in the diagnosis of sacroiliac joint arthropathy. BMC Surgery. 2013;13:52.  https://doi.org/10.1186/1471-2482-13-52
  16. Chang C-Y, Chiu Y-P, Ji H-R, et al. Surgical interventions for Bertolotti’s syndrome: case report and review of unsatisfactory cases in the literature. BMC Surgery. 2022;22(1):36.  https://doi.org/10.1186/s12893-022-01498-y
  17. Bureta CA, Yamamoto T, Ishidou Y, et al. Extraforaminal L5 Nerve Root Compression Caused by Intervertebral Ostheophyty Accompanied by Lumbosacral Transitional Vertebrae: A Case Treated by Anterior Approach. World Neurosurg. 2019;127:464-468.  https://doi.org/10.1016/j.wneu.2019.04.104
  18. Kojo S, Takahaschi K, Takumi TT, et al. Lumbar radiculopathy due to Bertolotti’s syndrome: Alternative method to reveal the «hidden zone» — A report of two cases and review of literature. J Orthop Sci. 2022;S0949-2658(22)00063-X. 
  19. Miyoshi M, Yasuhara T, Date I. Posterior decompression of far-out foraminal stenosis caused by a lumbosacral transitional vertebra-case report. Neurol Med Chir (Tokyo). 2011;51(2):153-156.  https://doi.org/10.2176/nmc.51.153
  20. Ali L, Ahmad K, Ali U. A rare case of low backache (Bertolotti′s Syndrome). Anest Pain Intensive Care. 2021;25(2):402-405. 
  21. Ryabko EV, Ryabchikov IV, Varaksin AN. Assessment of pain intensity in patients after arthroscopic surgery on the knee joint. Medicina. Sociologiya. Filosofiya. Prikladnye Issledovaniya. 2020;5:29-35. (In Russ.).
  22. Kurt EE, Turkyilmaz AK, Dadali Y, et al. Are Transitional Vertebra and Spina Bifida occulta Related with Lumbar Disc Herniation and Clinical Parameters in Young patients with Chronic Low Back Pain? Eurasian J Med. 2016;48(3):177-180.  https://doi.org/10.5152/eurasianjmed.2016.0285
  23. Milicić G, Krolo I, Anticević D, et al. Causal connection of non-specific low back pain and disc degeneration in children with transitional vertebra and/or Spina bifida occulta: role of magnetic resonance-prospective study. Coll Antropol. 2012;36(2):627-633. 
  24. Ahn S-S, Chin D-K, Kim S-H, et al. Clinical significance of lumbosacral transitional vertebrae on surgical outcomes of lumbar discectomy: a retrospective cohort study in young adults. World Neurosurg. 2017;99:745-750.  https://doi.org/10.1016/j.wneu.2016.05.073
  25. Ju CI, Kim SW, Kim JG, et al. Decompressive L5 Transverse Processectomy for Bertolotti′s Syndrome: A Preliminary Study. Pain Physician. 2017;20(6):923-932. 
  26. Park MK, Son SK, Park WW, et al. UnilataralBiportal Endoscopy for Decompression of Extraforaminal Stenosis at the Lumbosacral Junction: Surgical Techniques and Clinical Outcomes. Neurospine. 2021;18(4):871-879.  https://doi.org/10.14245/ns.2142146.073
  27. Chiang GT, Anuar MSB, Ibrahim KB, et al. A Case Reports of Intra-Articular Steroid Injection in the Treatment of Bertolotti’s Syndrome. AJORR. 2018;1(2):1-6. 
  28. Ravikant R, Majumdar P. Bertolotty’s syndrome in low-backache population: Classification and imaging finding. Ci Ji Yi Xue Za Zhi. 2019;31(2):90-95.  https://doi.org/10.4103/tcmj.tcmj_209_17
  29. Jacobs DK. A 15-year-old Female Cross Country Runner with Bertolotti’s Syndrome with an Intra-articular Injection at the Pseudoartriculation Site. PM&R. 2019;11(2):6-8. 
  30. Glemarek J, Varin S, Cozic C, et al. Efficacy of local glucocorticoid after local anesthetic in low back pain with lumbosacral transitional vertebra: A randomized placebo-controlled double-blind trial. Joint Bone Spine. 2018;85(3):359-363.  https://doi.org/10.1016/j.jbspin.2017.05.003
  31. Heo DH, Sharma S, Park CK. Endoscopic Treatment of Extraforaminal Entrapment of L5 Nerve Root (Far Out Syndrome) by Unilateral Biportal Endoscopic Approach: Technical Report and Preliminary Clinical Results. Neurospine. 2019;16(1):130-137.  https://doi.org/10.14245/ns.1938026.013
  32. Yavuz U, Bayhan AI, Beng K, et al. Low back complaints worse, but not more frequent in subjects with congenital lumbosacral malformetions: a study on 500 recruits. Acta OrthopBelq. 2012;78(5):668-671. 
  33. Kim MH, Bae YH, Kim HS, et al. The clinical report of the chronic HIVD patient with sacralization treated with quadrates lumborum MST (motion style treatment). The Journal of Korea CHUNA Manual Medicine for Spine and Nerves. 2014;9(2):11-19. 
  34. Han J, Park B, Son J, et al. Effects of Korean Medicine Treatment for a Patient with Lumbar Radiculopathy Diasgnosed with Bertolotti′s Syndrome: A Case Report. J Korean Med Rahabil. 2021;31(4):203-210.  https://doi.org/10.18325/jkmr.2021.31.4.203
  35. Mikula AL, Lakomkin N, Ransom RC, et al. Operative Treatment of Bertolotti′s Syndrome: Resection Versus Fusion. World Neurosurg. 2022;165:311-316.  https://doi.org/10.1016/j.wneu.2022.06.042
  36. Bhagchandani C, Murugan C, Jakkepally S, et al. A Whole Spine MRI Based Study of the Prevalence, Associated Disc Degeneration and Anatomical Correlations of Lumbosacral Transitional Vertebra. Global Spine J. 2023;21925682231151559. https://doi.org/10.1177/21925682231161559
  37. Iwasaki M, Akiyma M, Koyanagi I, et al. Double Cruch of L5 Spinal Nerve Root due to L4/L5 Lateral Recess Stenosis and Bony Spur Formation of Lumbosacral Transitional Vertebra Pseudoarticulation: A Case Report and Review. NMC Case Rep J. 2017;4(4):121-125.  https://doi.org/10.2176/nmccrj.cr.2016-0308
  38. Kanematsu R, Hanakita J, Takahashi T, et al. Extraforaminal entrapment of the fifth lumbar spinal nerve by neoarthrosis in patients with lumbosacral transitional vertebrae. Eur Spine J. 2020;29(9):2215-2221. https://doi.org/10.1007/s00586-020-06460-1
  39. Sumarriva G, Cook B, Celestre P. Surgical Resection of Bertolotti Syndrome. Ochsner J. 2022;22(1):76-79.  https://doi.org/10.31486/toj.21.0012
  40. Crane J, Cragon R, O’Neill J, et al. A Comprehensive Update of the Treatment and Management of Bertolotti’s Syndrome: A Best Practices Review. Orthop Rev (Pavia). 2021;13(2):24980. https://doi.org/10.52965/001c.24980
  41. Kavtharani S, Bsat SA, El Housheimy M, et al. A case of Bertolotti’s syndrome as a cause of sciatica. Surg Neurol Int. 2021;12:516.  https://doi.org/10.25259/SNI_756_2021
  42. Adams R, Herrera-Nicol S, Jenkins AL. 3rd Surgical Treatment of a Rare Presentation of Bertolotti′s Syndrome from Castellvi Type IV Lumbosacral Transitional Vertebrae: Case Report and Review of the Literature. J Neurol Surg Rep. 2018;79(3):70-74.  https://doi.org/10.1055/s-0038-1667172
  43. Golubovsky JL, Momin A, Thompson NR, et al. Understanding quality of life and treatment history of patients with Bertolotti syndrome compared with lumbosacral radiculopathy. J Neurosurg Spine. 2019;19:1-7.  https://doi.org/10.3171/2019.2.SPINE1953
  44. Sahoo RK, Kar R, Patel R, et al. Low back pain from Bertolotti′s syndrome: A not-so-uncommon etiology. Indian J Anaesth. 2020;64(8):729-731.  https://doi.org/10.4103/ija.IJA_348_20
  45. Burnham R. Radiofreguence Sensory Ablation as a Treatment for Symptomatic Unilateral Lumbosacral Junction Pseudarticulation (Bertolotti’s Syndrome): A Case Report. Pain Medicine. 2010;11(6):853-855.  https://doi.org/10.1111/j.1526-4637.2010.00869.x
  46. Daniel IP, Joel JJ, Rana PK. Lumbosacral transitional vertebra in patients with low back pain: Radiological classification and morphometric analysis. J Anat Soc India. 2019;68:123-128.  https://doi.org/10.4103/JASI.JASI_61_19
  47. Kapetanakis S, Chaniotakis C, Paraskevopoulos C, et al. An Unusual Case Report of Bertolotti′s Syndrome: Extraforaminal Stenosis and L5 Unilateral Root Compression (Castellvi Type III an LSTV). J Orthop Case Rep. 2017;7(3):9-12. 
  48. Gopalan B, Yerramshetty JS. Lumbosacral transitional vertebra — related low back pain: resolving the controversy. Asian Spine J. 2018;12(3):407.  https://doi.org/10.4184/asj.2018.12.3.407
  49. Alonzo F, Cobar A, Cahueque M, et al. Bertolotti′s Syndrome: an underdiagnosed cause for lower back pain. J Surg Case Rep. 2018;2018(10):rjy276. https://doi.org/10.1093/jscr/rjy276
  50. Hanhivaara J, Maatta JH, Karppinen A, et al. The association of lumbosacral trancitional vertebrae with low back pain and lumbar degenerative fin-dings in MRI: A large cohort study. Spine. 2022;47(2):153-162.  https://doi.org/10.1097/BRS.0000000000004244
  51. Skryabin EG, Nazarova AS, Zotov PB, et al. Lumbosacral transitional vertebrae in children and adolescents with lumbar spine injury: frequency of diagnosis and features of clinical symptoms. Genij Ortopedii. 2023;29(1):43-48. (In Russ.). https://doi.org/10.18019/1028-4427-2023-29-1-43-48
  52. Lee CS, Ha JK, Kim DG, et al. The clinical importance of lumbosacral transitional vertebrae in patients with adolescent idiopathic scoliosis. Spine. 2015;40(17):964-970.  https://doi.org/10.1097/BRS.0000000000000945
  53. Belabbes S, Doumbeneny MJ, Chavihoy C, et al. Bertolotti′s Syndrome: An Underdiagnosed Cause for Lower Back pain in Young Adults. SAS J Med. 2022;8(4):332-337.  https://doi.org/10.36347/sasjm.2022.v08i04.022
  54. Vinderlikh ME, Weiss Hassan AM, Nasybullina AA. Musculoskeletal disorders in pregnant women. Vestnik Volgogradskogo Gosudarstvennogo Medicinskogo Universiteta. 2022;19(3):101-107. (In Russ.). https://doi.org/10.19163/1994-9480-2022-19-3-101-107
  55. Santaguida PL, Gross A, Busse J. Complementary and alternative medicine in back pain utilization report. Evidence Report/Technology Assessment. 2009;(177):1-221. 
  56. Sherman KJ, Cherkin DC, Connelly MT, et al. Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try? BMC Complement Altern Med. 2004;4:9.  https://doi.org/10.1186/1472-6882-4-9
  57. Zeiger A, Kern A, Barth J, et al. Do patients’ pre-treatment expectations about acupuncture effectiveness predict treatment outcome in patients with chronic low back pain? A secondary analysis of data from a randomised controlled clinical trial. PLoS One. 2022;17(5):0268646. https://doi.org/10.1371/journal.pone.0268646
  58. Yun M, Chao Y, Zhang Y. Hegu acupuncture for chronic low-back pain: a randomized controlled trial. J Altern Complement Med. 2012;18(2):130-136.  https://doi.org/10.1089/acm.2010.0779
  59. Zhou J, Wang J, Chen Z, et al. Efficacy Analysis of the Reinforcing and Circulation-Promoting Protocol of Acupuncture and Moxibustion in Treatment of Twenty-Four Patients with Refractory Chronic Low Back Pain. Evid Based Complement Alternat Med. 2022;2022:8734207. https://doi.org/10.1155/2022/8734207
  60. Zhang Y, Wanj C. Acupuncture and Chronic Musculoskeletal Pain. Curr Rheumatol Rep. 2020;22(11):80.  https://doi.org/10.1007/s11926-020-00954-z
  61. Ivanichev GA. Pain as an integrative function of the body. Reception and perception of nociceptive flow. Al′ternativnaja Medicine. 2006;2:4. (In Russ.).
  62. Yu S, Ortiz A, Gollub RK, et al. Acupuncture Treatment Modulates the Connectivity of Key Regions of the Descending Pain Modulation and Reward Systems in Patients with Chronic Low Back Pain. J ClinMed. 2020;9(6):1719. https://doi.org/10.3390/jcm9061719
  63. Yin C, Bucheit TE, Park JJ. Acupuncture for chronic pain: an update and critical overview. Curr Opin Anaesthesiol. 2017;30(5):583-592.  https://doi.org/10.1097/ACO.0000000000000501
  64. Yulin VS, Shpagin MV, Kolesnikov MV. Bertolotti′s Syndrome. Trudnyj Pacient. 2020;18(3):13-16. (In Russ.). https://doi.org/10.24411/2074-1995-2020-10012
  65. Celenlioglu AE, Sensan S, Bilim S, et al. Comparison of Caudal Versus Transforaminal Epidural Steroid Injection in Post Lumbar Surgery Syndrome After Single-level Discectomy: A Prospective Randomizid Trial. Pain Physician. 2022;25(2):161-169. 
  66. Dhanjani S, Altaleb M, Marqalit A, et al. Pediatric Back Pain Associated with Bertolotti Syndrome: A Report of 3 Cases with Varying Treatment Strategies. JBJS Case Connect. 2021;11(4):2100068. https://doi.org/10.2106/JBJS.CC.21.00068
  67. Li Y, Lubelski D, Abdullah KG, et al. Minimally invasive tubular resection of the anomalous transverse process in patients with Bertolotti′s syndrome:presented at the 2013 Joint Spine Section Meeting: clinical article. J Neurosurg Spine. 2014;20(3):283-290.  https://doi.org/10.3171/2013.11.SPINE13132
  68. Jenkins AL 3rd, Chung RJ, O’Donnell J, et al. Redefining the Treatment of Lumbosacral Transitional Vertebrae for Bertolotti′s Syndrome: Long-Term Outcomes Utilizing the Jenkins Classification to Determine Treatment. World Neurosurg. 2023;1878-8750(23)00308-X.  https://doi.org/10.1016/j.wneu.2023.03.012

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.