Intraoperative navigation-guided resection of anomalous transverse processes in patients with Bertolotti's syndrome.

Document Type

Article

Publication Date

1-1-2017

Publication Title

Surg Neurol Int

Keywords

Bertolotti's syndrome; pseudoarticulation; sacrum; transverse process

Abstract

BACKGROUND: 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.

CASE DESCRIPTIONS: 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.

CONCLUSION: 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.

Clinical Institute

Neurosciences (Brain & Spine)

Department

Orthopedics

Department

Neurosciences

Department

Surgery

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