Babu Harish, Lagman Carlito, Kim Terrence T, Grode Marshall, Johnson J Patrick, Drazin Doniel
Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, United States.
Department of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California, United States.
Surg Neurol Int. 2017 Sep 26;8:236. doi: 10.4103/sni.sni_173_17. eCollection 2017.
Bertolotti's syndrome is characterized by enlargement of the transverse process at the most caudal lumbar vertebra with a pseudoarticulation between the transverse process and sacral ala. Here, we describe the use of intraoperative three-dimensional image-guided navigation in the resection of anomalous transverse processes in two patients with Bertolotti's syndrome.
Two patients diagnosed with Bertolotti's syndrome who had undergone the above-mentioned procedure were identified. The patients were 17- and 38-years-old, and presented with severe, chronic low back pain that was resistant to conservative treatment. Imaging revealed lumbosacral transitional vertebrae at the level of L5-S1, which was consistent with Bertolotti's syndrome. Injections of the pseudoarticulations resulted in only temporary symptomatic relief. Thus, the patients subsequently underwent O-arm neuronavigational resection of the bony defects. Both patients experienced immediate pain resolution (documented on the postoperative notes) and remained asymptomatic 1 year later.
Intraoperative three-dimensional imaging and navigation guidance facilitated the resection of anomalous transverse processes in two patients with Bertolotti's syndrome. Excellent outcomes were achieved in both patients.
贝托洛蒂综合征的特征是最尾侧腰椎横突增大，横突与骶骨翼之间存在假关节。在此，我们描述了术中三维图像引导导航在两名贝托洛蒂综合征患者异常横突切除术中的应用。
确定了两名接受上述手术的贝托洛蒂综合征患者。患者分别为17岁和38岁，均表现为严重的慢性腰痛，保守治疗无效。影像学检查显示L5-S1水平存在腰骶部移行椎，符合贝托洛蒂综合征。对假关节进行注射仅能暂时缓解症状。因此，这两名患者随后接受了O型臂神经导航下的骨缺损切除术。两名患者术后疼痛均立即缓解（术后记录有记载），且1年后均无症状。
术中三维成像和导航引导有助于两名贝托洛蒂综合征患者异常横突的切除。两名患者均取得了良好的效果。
