Bertolotti’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. Bertolotti’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 Bertolotti’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 Bertolotti’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.