Department of Anesthesia, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Korean J Pain. 2013 Oct;26(4):368-73. doi: 10.3344/kjp.2013.26.4.368. Epub 2013 Oct 2.
Bertolotti's syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS.
All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief.
All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor.
Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.
Bertolotti 综合征（BS）是腰骶移行椎引起腰背痛的一种类型，是青年患者腰痛的重要病因。本研究旨在评估 BS 患者腰痛的病因和治疗效果。
本研究纳入了 6 个月内确诊为 Castellvi 1a 型 BS 的所有患者。对患者行介入性疼痛治疗以明确诊断并缓解疼痛。通过 VAS 和 ODI 评分评估治疗反应。VAS 评分降低 50%或 VAS 评分<3 分视为疼痛缓解满意。
在 6 个月的观察期间，所有 20 例诊断为 BS 的患者均有脊柱侧凸。常见的腰痛病因包括同侧 L5-S1 小关节、新形成的关节、骶髂关节和椎间盘退变。各种缓解疼痛的干预措施的反应不同，且在患者之间不一致。特别是对新形成关节疼痛的干预反应通常较差。
BS 患者的疼痛通常对介入性疼痛治疗无反应。在管理 BS 患者时必须采取非常积极的治疗方法，并且必须在各个阶段个体化治疗计划，以获得满意的疼痛缓解。
