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Operative Treatment of Bertolotti Syndrome: Resection Versus Fusion
Anthony L Mikula1, Nikita Lakomkin1, Ryan C Ransom1
1Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA.
World Neurosurgery
|June 18, 2022
Summary
Surgical fusion for Bertolotti syndrome offers better long-term pain relief than joint resection. This study compared operative treatments, finding fusion superior for sustained improvement in patients with this spinal condition.
Area of Science:
- Orthopedic Surgery
- Spine Surgery
- Pain Management
Background:
- Bertolotti syndrome involves a congenital abnormality of the lumbosacral vertebrae, often causing chronic back and leg pain.
- Operative management aims to alleviate pain by addressing the abnormal articulation.
Purpose of the Study:
- To compare the efficacy of joint resection versus spinal fusion in surgically treated Bertolotti syndrome patients.
- To evaluate long-term and short-term pain improvement outcomes between the two surgical techniques.
Main Methods:
- Retrospective chart review of patients with Bertolotti syndrome who underwent operative treatment.
- Comparison between patients treated with joint decompression/resection and those treated with fusion across the abnormal lumbosacral vertebrae.
- Exclusion of patients with other symptomatic spinal pathologies.
Main Results:
- Fusion (n=9) showed significantly higher long-term pain improvement (78%) compared to joint resection (n=18) (28%, P=0.037).
- No significant difference in short-term pain improvement (<6 months) between fusion (100%) and resection (78%) groups (P=0.27).
- Demographics, symptom presentation, radiographic subtype, and complication rates were similar between groups.
Conclusions:
- Surgical fusion across the transitional lumbosacral vertebrae yields better long-term pain relief for Bertolotti syndrome than resection of the pseudoarticulation.
- Fusion is a more effective surgical option for sustained pain reduction in Bertolotti syndrome.
