Bertolotti综合征是顽固性背痛的常见原因,影响了普通人群的4%至8%。它涉及过渡性腰骶椎的先天性畸形,与骶骨完全或部分和单侧或双侧横突(TP)融合或关节连接。疼痛可能使人衰弱,脊柱与骶骨的束缚可以促进冠状平面的畸形形成,并导致早期的退行性变化,特别是如果只是单方面存在。我们介绍了一个24岁的女性,没有明显的既往病史,她表现出多年的下轴向背痛,辐射到她的大腿,这限制了她的日常生活活动,并抵制保守的管理。她的影像显示左侧L5TP异常大,铰接在骶骨上,和早期冠状畸形的迹象。她对反复注射类固醇到TP-骶关节几乎完全有反应,但这种影响是非常短暂的。在她的手术之前获得患者知情同意。她接受了异常关节的微创管断开术,并对TP进行了部分远端切除,她的症状完全消失了.该病例强调了将临床症状与异常解剖相关联的重要性,以及选择性手术在缓解症状方面的作用。本病例报告是按照我们的机构伦理审查委员会的批准编写的,根据德克萨斯大学西南大学机构审查委员会提供的数据的回顾性和去识别性质,患者同意被放弃.
Bertolotti syndrome is a commonly missed cause of intractable back pain that affects 4% to 8% of the general population. It involves the congenital malformation of a transitional lumbosacral vertebra, with total or partial and unilateral or bilateral transverse process (TP) fusion or articulation to the sacrum. The pain can be debilitating, and the tethering of the spine to the sacrum can encourage deformity formation in the coronal plane and lead to early degenerative changes, especially if present only unilaterally. We present the case of a 24-yr-old woman with no notable prior medical history who presented with years of lower axial back pain radiating to her thighs, which limited her activities of daily living and was resistant to conservative management. Her imaging showed an abnormally large left L5 TP, which was articulated to the sacrum, and signs of early coronal deformity. She had responded almost completely to repeated steroid injections into the TP-sacral joint, but that effect was very transient. Informed patient consent was obtained prior to her surgery. She underwent a minimally invasive tube disconnection of the abnormal joint with partial distal resection of the TP, and her symptoms completely resolved. This case highlights the importance of correlating clinical symptoms with aberrant anatomy, and the role of selective surgery in providing symptomatic relief. This case report was written in compliance with our institutional ethical review board approval, and patient consent was waived in light of the retrospective and deidentified nature of the data presented in accordance with the University of Texas Southwestern institutional review board.