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Partial lumbosacral transitional vertebra resection for contralateral facetogenic pain
J S Brault1, J Smith, B L Currier
1Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota 55905, USA.
Spine
|January 12, 2001
Summary
Surgical resection of a contralateral anomalous articulation successfully treated mechanical low back pain in a young patient with Bertolotti's syndrome. This addresses pain from the facet joint opposite the anomaly.
Area of Science:
- Orthopedics
- Spine Surgery
- Pain Management
Background:
- Bertolotti's syndrome, associated with lumbosacral transitional vertebrae, causes mechanical low back pain.
- The pathophysiology and pain generation of these segments are not well understood.
- Surgical treatment for Bertolotti's syndrome is infrequently reported and controversial.
Observation:
- A 17-year-old cheerleader presented with mechanical low back pain.
- Diagnostic evaluation implicated the L6-S1 facet joint contralateral to a unilateral anomalous lumbosacral articulation.
- Fluoroscopically guided injections confirmed the symptomatic facet joint.
Findings:
- Surgical resection of the anomalous lumbosacral articulation was performed.
- The patient experienced a successful surgical outcome.
- This suggests reduced stress on the symptomatic facet joint.
Implications:
- Clinicians should consider contralateral facet joint pain in Bertolotti's syndrome, even in young patients.
- Resection of the anomalous articulation can provide excellent results for surgical management.
- This case highlights an effective treatment for a rare cause of mechanical low back pain.