Bertolotti's Syndrome , An Important Etiology of Low Back Pain On X ray Lumbo-sacral Spine Among Young Population


  • Nadia Gul Associate Professor Radiology POF Hospital wah cantt
  • Khalid Mehmood Consultant Neurosurgeon, Department of Neurosurgery, CMH Rawalpindi
  • Abdul Aziz Niazi Consultant Radiologist, CDA Hospital Islamabad


Bertolotti’s syndrome, Castellvi classification, lumbosacral transitional vertebra


Objective:  To find out frequency of Bertolotti’s syndrome on X–ray lumbosacral spine in young adults having low backache.
Methodology:This is retrospective descriptive cross sectional study done in Radiology Department POF hospital Wah Cantt, from Nov 2017 to Oct 2019. Sample size was 600 X-ray lumbosacral spine of patients with low back pain between 15-40 years of age. 200 cases with history of trauma were excluded. Data analysis of 400 included cases was done by SPSS-22. Percentage of etiologies of low backache, lumbosacral transitional vertebra (LSTV), Bertolotti’s syndrome and Castellvi types of LSTV was calculated. Mean age with SD and percentage of gender distribution among cases of Bertolotti’s syndrome was calculated.
Results: Among 400 patients, 120 (30%) had LSTV, 264 (66%)  had muscle spasm, 6(1.5%) had Pott’s disease and 10 (2.5%) had spinal metastasis. 120 patients with LSTV, 32 ( 26.6%)  had Bertolotti’s syndrome and 88(73.3%) had normal transverse processes. Mean age with Bertolotti syndrome was 29.96+0.417 years. 20 patients (62%, n=32) were female and 12 (37.5%, n=32) were male. Among 32 patients with Bertolotti’s syndrome, 4 (12.5%) were Castellvi type–I, 10 (31.25%) were Castellvi type-II, 12 (37.5%) were Castellvi type-III and 6 (18.7%) were Castellvi type- IV.
Conclusion: Bertolotti’s syndrome is a frequently observed etiology of backache in young patients. Importance of imaging is not only in the diagnosis but also in identification and exact enumeration of LSTV, to avoid unintended level treatment.





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