Bertolotti综合症真的存在吗？系统综述

IF 0.4 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-03-14 DOI:10.1016/j.inat.2025.102008

Acevedo-Gonzalez Juan Carlos , Delgado-Caicedo Mónica Gabriela , Lacouture-Silgado Isabella

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引用次数: 0

摘要

研究设计系统评价。目的bertolotti综合征被描述为腰骶棘过渡性异常与腰痛之间的关系。这种关联是非特异性的，不能作为对这种异常进行外科手术的理由，即使是经皮或微创手术。我们认为，腰骶交界处的先天性变异是改变脊柱正常生物力学的因素，有利于其他已知的疼痛病理的发展。这项工作是一项系统综述，旨在确定Bertolotti综合征是否应被视为腰背痛的独立病因，还是仅作为发生产生疼痛的生物力学改变的危险因素（腰骶过渡椎）。方法检索检索词（PubMed, Embase, Cochrane library，临床试验）：Bertolotti综合征，腰痛，腰骶过渡椎。这项研究涵盖了过去21年（2013年至2024年）。“Rayyan”计划被用来收集信息和促进分析过程。每位作者都审阅了所发现文章的摘要。纳入：系统综述、临床试验、观察性研究和病例系列。排除：理论文章、叙述性评论和非英语语言的文章。初步分析：285篇文献入选（PubMed-115, Scopus-76, Embase-94）， 238篇文献被排除（由于重复文章或标题不符合纳入/排除标准）。入选文献47篇，其中回顾性临床研究25篇，病例系列12篇，随机临床试验3篇，系统评价7篇；未发现荟萃分析)。采用PRISMA检查表，并使用STROBE和CONSORT检查表对每篇文章进行评估。结论腰骶交界处先天性异常患者的慢性背痛需要广泛的临床和放射学评估，以确定症状来源的原因。移行性异常只是改变腰骶棘正常生物力学的危险因素，而不是治疗目标。Bertolotti综合征是一种轶事性但非客观的疼痛起源关联。

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Bertolotti Syndrome: Does it really exist? systematic review

Study Design

systematic review.

Objectives

Bertolotti syndrome is described as the association between low back pain and transitional abnormalities of the lumbosacral spine. This association is nonspecific and does not justify surgical procedures on this anomaly, even percutaneous or minimally invasive. We consider that congenital variations of the lumbosacral junction are elements that modify the normal biomechanics of the spine and favor the development of other painful pathologies already known. This work is a systematic review that aims to determine whether Bertolotti Syndrome should be considered as an independent etiology of low back pain or only as a risk factor (Lumbosacral transitional vertebrae) for developing biomechanical alterations that produce pain.

Methods

The search used the following terms (PubMed, Embase, Cochrane library and clinical trials): Bertolotti syndrome, low back pain, lumbosacral transitional vertebrae. The search covered the last 21 years (2013 to 2024). The “Rayyan” program was used to gather information and facilitate the analysis process. Each author reviewed the abstract of the articles found. Inclusion: Systematic reviews, clinical trials, observational studies, and case series. Exclusion: Theoretical articles, narrative reviews, and articles in languages other than English.

Results

Initial analysis: 285 articles were selected (PubMed-115, Scopus-76, Embase-94), 238 articles were excluded (due to duplicated articles or titles not meeting inclusion/exclusion criteria). 47 articles were selected (25 retrospective clinical studies, 12 case series, 3 randomized clinical trial, and 7 systematic reviews; meta-analyses were not found). The PRISMA checklist was applied, and each article were assessed using the STROBE and CONSORT checklists.

Conclusions

Low back pain in patients with congenital abnormalities of the lumbosacral junction requires extensive clinical and radiological evaluation to determine the cause of the source of symptoms. Transitional anomaly is only a risk factor that modifies the normal biomechanics of the lumbosacral spine and not the therapeutic target. Bertolotti syndrome is an anecdotal but not objective association of the origin of pain.

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