Oral pharmacological management of Bertolotti syndrome presenting as chronic low back pain – A case report and review of literature

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2024-10-21 DOI:10.1016/j.jor.2024.10.028

Saarim Bari , Varun Menon , Shankar Bhuvanesh

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引用次数: 0

Abstract

Background

Bertolotti syndrome (BS) is often a missed cause of chronic lower back pain in young individuals, commonly associated with the presence of anomalous lumbosacral transitional vertebrae.

Case presentation

A 19-year-old female with no significant medical or family history presented with persistent lower back pain localized to the gluteal region and posterolateral aspect of the left lower back. The pain worsened over time and limited their movements, including walking. A Ferguson radiograph revealed fusion of the left transverse process of the L5 vertebral segment with the left sacral ala. History, examination findings, and radiological workup confirmed the diagnosis of BS. The patient preferred conservative management, receiving oral pharmacological therapy for six weeks, along with education on preventive measures and routine exercises for postural stability. At a six-month follow-up, the patient remained asymptomatic and managed well.

Conclusions

Conservative oral pharmacological treatment presents a unique and viable alternative to traditional methods for managing BS, which often involve surgery or steroids/anesthetics at the pseudo-articulation site. Given that BS is common yet underdiagnosed in young patients with chronic back pain, this report also underscores the importance of including it in differential diagnoses for chronic lower back pain in this demographic.

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以慢性腰痛为表现的贝托洛蒂综合征的口服药物治疗--病例报告和文献综述

背景贝尔托洛蒂综合征（Bertolotti syndrome，BS）常常是年轻人慢性下背痛的一个被忽视的病因，通常与腰骶部过渡椎体异常有关。病例介绍一名无明显病史或家族史的 19 岁女性因持续性下背痛就诊，疼痛部位位于臀部和左下背部后外侧。随着时间的推移，疼痛逐渐加剧，并限制了其行动，包括行走。弗格森X光片显示，L5椎体左侧横突与左侧骶骨融合。病史、检查结果和放射学检查证实了 BS 的诊断。患者选择了保守治疗，接受了为期六周的口服药物治疗，同时接受了预防措施教育和姿势稳定的常规锻炼。结论保守的口服药物治疗是治疗 BS 的传统方法的一种独特而可行的替代方法，传统方法通常需要在假关节部位进行手术或使用类固醇/麻醉剂。鉴于 BS 在慢性背痛的年轻患者中很常见，但诊断不足，本报告还强调了将其纳入慢性下背痛鉴别诊断的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.