RT Journal Article SR Electronic T1 Surgical Resection of Bertolotti Syndrome JF Ochsner Journal JO Ochsner J FD O. P. Jindal Global University SP 76 OP 79 DO 10.31486/toj.21.0012 VO 22 IS 1 A1 Sumarriva, Gonzalo A1 Cook, Brandon A1 Celestre, Paul YR 2022 UL http://www.ochsnerjournal.org/content/22/1/76.abstract AB Background: Bertolotti syndrome is the association of lumbosacral transitional vertebrae and low back pain or sciatica. Lumbosacral transitional vertebrae are vertebrae with large transverse processes that (1) articulate or fuse with the sacrum or ilium and (2) have a caudal disc space. Bertolotti syndrome is relatively common, with an incidence of 4.6% to 7% in patients with low back pain. The exact etiology of Bertolotti syndrome remains uncertain, although several hypotheses have been proposed.Case Report: A 17-year-old male presented with a long history of low back pain refractory to conservative treatment including medications, activity modification, and physical therapy. Unilateral Bertolotti syndrome was suspected. The diagnosis was confirmed with bupivacaine injection at the transitional articulation. The patient was treated with surgical resection of his enlarged left-sided L5 transverse process, resulting in complete resolution of pain.Conclusion: Lumbosacral transitional vertebrae are relatively common, so Bertolotti syndrome should be on the list of differential diagnoses for low back pain.