What is Bertolotti Syndrome?
Bertolotti Syndrome is a congenital condition, meaning you are born with it. It is one of the most common causes of undiagnosed or misdiagnosed lower back pain and sciatica. Many patients with this condition are incorrectly treated, leading to ineffective therapies or unnecessary surgeries.
To understand Bertolotti Syndrome, it’s helpful to know how the spine is structured:
- Cervical Spine (Neck): Seven vertebrae at the top of the spine.
- Thoracic Spine (Mid-Back): Twelve vertebrae that connect to the ribs.
- Lumbar Spine (Lower Back): Five vertebrae and discs providing support and flexibility.
In a typical spine, each lumbar vertebra functions independently. However, in Bertolotti Syndrome, the fifth lumbar vertebra (L5) develops a bony connection, or “bridge,” to the pelvis on one or both sides. This partial fusion creates a “pseudo joint,” limiting the natural movement of the vertebra and placing excessive strain on the surrounding structures.
Symptoms and Progression
Although present at birth, Bertolotti Syndrome often becomes symptomatic in the mid-20s to mid-30s due to years of compensation by the spine and joints above the fused segment. Common symptoms include:
- Persistent lower back pain.
- Sciatica, or pain radiating down the leg.
- Accelerated degeneration in the adjacent vertebrae and discs.
- Disc ruptures or herniations at the L4-L5 level, causing increased pain and mobility issues.
When both sides of the vertebrae are fused to the pelvis, the level above (L4-L5) experiences increased stiffness, leading to faster degeneration and worsening symptoms.
How is Bertolotti Syndrome Treated?
Non-Surgical Treatments:
Physical Therapy: The first line of treatment often involves core-strengthening and trunk-stability exercises. While it may not fully relieve symptoms, physical therapy helps protect the rest of the spine by improving strength and flexibility.
Surgical Treatment:
For patients whose symptoms persist despite conservative treatments, Dr. Melamed offers a groundbreaking, minimally invasive solution. Dr. Melamed has pioneered an ultra-minimally invasive endoscopic procedure using CT-guided navigational technology, making the treatment safer and more precise.
How the Procedure Works:
- The bony “bridge” connecting the L5 vertebra to the pelvis is carefully removed.
- Underlying ligaments tethering the vertebrae are released.
- The result: The L5 vertebra regains its natural mobility, reducing strain on the levels above and alleviating pain.
Patients often experience immediate symptom relief and a significant improvement in mobility. The procedure minimizes future degeneration and reduces the likelihood of additional complications.
Recovery After Surgery
Dr. Melamed’s technique is designed to allow for a rapid recovery:
- Most patients can drive within a day and return to work in a few days.
- Full participation in sports and other activities is typically possible within two weeks.
- Unlike traditional treatments involving fusion or artificial discs, this approach avoids complications from unnecessary hardware.
Why Traditional Treatments Fail?
Unfortunately, many patients with Bertolotti Syndrome are offered traditional surgeries like fusion with rods and screws or artificial discs, which often fail to address the root cause of the problem. These procedures can lead to poor outcomes and additional surgeries.
If you have been diagnosed with Bertolotti Syndrome or are experiencing persistent back pain, we strongly recommend seeking a second opinion before committing to fusion or artificial disc replacement. Correctly diagnosing and treating Bertolotti Syndrome is essential for lasting relief.
Get the Right Treatment
If you are dealing with lower back pain or sciatica, especially if you’ve been recommended for fusion or other major surgeries, consult Dr. Melamed. His innovative approach offers a safer, more effective alternative to traditional treatments.
For more information or to schedule a consultation, call us today at 424-21-SPINE.
