Bertolottiâ€™s syndrome is characterised by anomalous enlargement of the transverse process(es) of the most caudal lumbar vertebra which may articulate or fuse with the sacrum or ilium and cause isolated L4/5 disc disease. This study analysed the elective MR scans of the lumbosacral spine of 769 consecutive patients with low back pain, of these 568 showed disc degeneration. Bertolottiâ€™s syndrome was present in 35 patients with a mean age of 32.7 years (15 to 60). This was a younger age than that of patients with multiple disc degeneration, single-level disease and isolated disc degeneration at the L4/5 level (p 0.05). The overall incidence of Bertolottiâ€™s syndrome in this study was 4.6% (35 of 769) and it was present in 11.4% (20 patients) of the under-30 age group. The findings suggest that Bertolottiâ€™s syndrome must form part of a list of differential diagnoses in the investigation of low back pain in young people.
Journal of Bone and Joint Surgery – British Volume, Vol 88-B, Issue 9, 1183-1186.