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Anterior pseudoarthrectomy for symptomatic Bertolotti's syndrome.
Gregory M Malham1, Rebecca J Limb, Matthew H Claydon
1Epworth Hospital, Richmond, Melbourne, VIC, Australia.
Summary
Anterior retroperitoneal approach successfully treated severe L5/S1 pseudoarthrosis in Bertolotti's syndrome. This minimally invasive technique provided long-term pain relief and radiological improvement in two patients.
Area of Science:
- Spine Surgery
- Orthopedics
- Minimally Invasive Procedures
Background:
- Bertolotti's syndrome, characterized by painful L5/S1 pseudoarthrosis, traditionally managed with posterior excision or lumbar fusion.
- The anterior retroperitoneal approach for L5/S1 pseudoarthrectomy in Bertolotti's syndrome has not been previously documented.
Observation:
- Two patients with severe symptomatic L5/S1 pseudoarthroses underwent surgical treatment.
- An anterior retroperitoneal approach was utilized for pseudoarthrectomy in both cases.
Findings:
- Successful excision of L5/S1 pseudoarthroses was achieved via the anterior retroperitoneal approach.
- Both patients experienced significant long-term symptomatic relief and demonstrated positive radiological outcomes at 2-year follow-up.
Implications:
- The anterior retroperitoneal approach appears to be a safe and effective option for managing symptomatic L5/S1 pseudoarthrosis in Bertolotti's syndrome.
- Further comparative studies are warranted to evaluate anterior versus posterior pseudoarthrectomy outcomes for guiding clinical management.