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lüll Transitional lumbosacral vertebrae and low back pain: diagnostic pitfalls and management of Bertolotti s syndrome Almeida DB; Mattei TA; Soria MG; Prandini MN; Leal AG; Milano JB; Ramina RArq Neuropsiquiatr 2009[Jun]; 67 (2A): 268-72OBJECTIVE: Bertolotti's syndrome is a spine disorder characterized by the occurrence of a congenital lumbar transverse mega-apophysis in a transitional vertebral body that usually articulates with the sacrum or the iliac bone. It has been considered a possible cause of low back pain. METHOD: We analyzed the cases of Bertolotti's syndrome that failed clinical treatment and reviewed the literature concerning this subject. RESULTS: Five patients in our series had severe low back pain due to the neo-articulation and two of them were successfully submitted to surgical resection of the transverse mega-apophysis. Taking into account the clinical and surgical experience acquired with these cases, we propose a diagnostic-therapeutic algorithm. CONCLUSION: There is still no consensus about the most appropriate therapy for Bertolotti's syndrome. In patients in whom the mega-apophysis itself may be the source of back pain, surgical resection may be a safe and effective procedure.|Adult[MESH]|Female[MESH]|Humans[MESH]|Low Back Pain/*etiology/surgery[MESH]|Lumbar Vertebrae/*abnormalities/surgery[MESH]|Lumbosacral Region/surgery[MESH]|Syndrome[MESH]|Treatment Outcome[MESH] |