Elster A D
Department of Radiology, Bowman Gray School of Medicine, Winston-Salem, North Carolina.
Spine (Phila Pa 1976). 1989 Dec;14(12):1373-7.
Bertolotti's syndrome refers to the association of back pain with lumbosacral transitional vertebrae. Such vertebrae were observed in 140 of 2,000 adults with back pain over a 4-year period of study. Each patient had radiographic evaluation of the lumbar spine by plain films as well as a sectional imaging modality (magnetic resonance [MR] or computed tomography [CT]). The overall incidence of structural pathology (eg, spinal stenosis and disc protrusion) detected by CT or MR was not apparently higher in patients with transitional vertebrae, but the distribution of these lesions was significantly different. Disc bulge or herniation, when it occurred, was nearly nine times more common at the interspace immediately above the transitional vertebra than at any other level. Spinal stenosis and nerve root canal stenosis were more common at or near the interspace above the transitional vertebra than at any other level. Degenerative change at the articulation between the transverse process of the transitional vertebra and the pelvis was an uncommon occurrence; when seen there was no significant correlation with the reported side of pain. It is postulated that hypermobility and altered stresses become concentrated in the spine at the level immediately above a lumbar transitional vertebra. Accelerated disc and facet joint degeneration at this level may then result.
贝托洛蒂综合征指背痛与腰骶部移行椎相关。在一项为期4年的研究中，2000名背痛成人中有140人观察到此类椎体。每位患者均接受了腰椎X线平片以及断层成像检查（磁共振成像[MR]或计算机断层扫描[CT]）。CT或MR检测到的结构病理学病变（如椎管狭窄和椎间盘突出）的总体发生率在有移行椎的患者中并无明显升高，但这些病变的分布显著不同。椎间盘膨出或突出发生时，在移行椎上方紧邻的椎间隙处出现的几率几乎是其他任何节段的9倍。椎管狭窄和神经根管狭窄在移行椎上方的椎间隙处或其附近比在其他任何节段更常见。移行椎横突与骨盆之间关节的退变并不常见；出现时与所报告的疼痛侧无显著相关性。据推测，过度活动和应力改变会集中在腰骶部移行椎上方紧邻节段的脊柱。进而可能导致该节段椎间盘和小关节加速退变。
