Abstract
Background: Bertolotti's Syndrome is a congenital anomaly of the spine characterized by lumbosacral transitional vertebrae (LSTV) that is associated with lower back pain. For much of the world, back pain has been found to be the leading cause of loss of activity, work restrictions, and absenteeism. This has been associated with enormous economic burdens on a personal level, as well as for the wider economy. However, Bertolotti Syndrome is commonly overlooked both in terms of differential diagnosis and the treatment of back pain. Research indicates that 65-80% of people will experience back pain during their lives, and thus far, 4.6%-7% of those occurrences in adults have been associated with LSTV.Audience: This presentation aims to raise awareness of Bertolotti's Syndrome among both patients and physicians.
Approach: A literature review was conducted using a systematic search of academic databases, such as PubMed and NIH, using keywords including "Bertolotti's Syndrome," and "transitional vertebrae." Inclusion criteria focused on peer-reviewed articles published within the last ten years, emphasizing clinical studies, diagnostic methods, and treatment approaches. Landmark studies were included and referenced despite falling outside of the ten-year criteria. Relevant articles were then analyzed and synthesized to provide a comprehensive overview of current understanding and management practices related to Bertolotti's Syndrome.This presentation was originally designed for a Pathophysiology course at Cummings Institute for Behavioral Health. Elements of this presentation were gathered from collaboration and insight gained from the Facebook group "Bertolotti's Syndrome Education Group (USA)" - a support and education group for sufferers of this condition.
Results: Key findings indicate that Bertolotti's Syndrome is often underdiagnosed due to its overlapping symptoms with other, more common, back pain generating conditions, as well as an erroneous perception amongst physicians that LSTV cannot cause pain. Diagnostic advancements, such as the use of MRI and CT scans, have improved accuracy in identifying LSTV, yet variability in diagnostic criteria persists. Treatment approaches range from conservative management, including physical therapy and pain relief medication, to surgical interventions such as resection of the transitional vertebra or spinal fusion. The review suggests a trend towards individualized treatment plans, however, further studies are necessary to raise awareness of this condition and to develop standardized diagnostic and treatment guidelines.
Implications: This review highlights the pressing need for increased awareness, as well as standardized diagnostic criteria and treatment protocols. The findings underscore the importance of accurate diagnosis to differentiate Bertolotti's Syndrome from other pain generators. The audience will gain a deeper understanding of Bertolotti's Syndrome, including its prevalence, diagnostic challenges, treatment options, and patient frustrations. Bertolotti's Syndrome is a significant yet often overlooked cause of lower back pain, contributing to the broader issue of back pain that affects a large portion of the population and imposes substantial economic burdens. Despite advancements in imaging techniques, Bertolotti's Syndrome remains underdiagnosed due to symptom overlap with other conditions and misconceptions among healthcare providers regarding its potential to cause pain. There is a wide range of treatment options, from conservative management to surgical interventions, but the lack of standardized guidelines leads to variability in care. There is a need for increased awareness among healthcare providers about Bertolotti's Syndrome and its impact. Providers and patients should be updated on recently released literature that redefines how physicians approach this condition.