Discovering a rare cause for backache – A case report in Bertolotti syndrome

Bertolotti syndrome is one of the rare causes of chronic backache in all age groups. It is caused by an abnormally enlarged transverse process called “mega-apophysis” articulating with the sacrum or ileum leading to altered biomechanics of the spine.
A 16-year-old school-going girl with Castelli’s type II A was managed successfully with steroid and local anesthetic infiltration into the pseudoarticulation. An internet-based literature survey was conducted and the results were analyzed. 12 studies that describe the treatment modality of bertolotti syndrome were found.
The local infiltration of steroid and anesthetic agents can be used to diagnose or treat this entity. Recurrence of symptoms following infiltration deserved excision of mega-apophysis.