• The Korean Journal of Pain
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• v.12 no.1
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• pp.136-139
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• 1999

Bertolloti syndrome is the association between low back pain (LBP) and the presence of a lumbosacral transitional vertebrae. A transitional vertebrae is composed of one or both transverse process connecting with the sacrum or ilium and the presence of a vestigial intervertebral disc space caudal to the transitional vertebrae. We experienced a case of low back pain with intermittent radiating pain in patient with complete lumbosacral sacralization. Long term relief of low back pain was maintained with intra and/or periarticular infiltration of local anesthetics and steroid. The relief of LBP suggests a correlation between LBP and lumbosacral sacralization.

• Clinical Pain
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• v.20 no.1
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• pp.49-52
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• 2021

Bertolotti's syndrome (BS) refers to chronic low back pain (LBP) associated with lumbosacral transitional vertebrae (LSTV). Many studies suggest that the anomalous articulation alters biomechanics, resulting in discomfort on the ipsilateral side. Herein, we present an unusual case of BS presenting pain on the non-articulated side. A 46-year-old man visited our clinic with history of chronic LBP, refractory to treatment of analgesics, modalities and manual therapies. Electrodiagnostic studies showed no evidence of lumbosacral radiculopathy. Radiographies noted unilateral pseudoarticulation of L5~S1 vertebrae, on the contralateral side of his pain. The pain improved dramatically after sacroiliac joint block and facet joint block with iliolumbar ligament infiltration on the non-articulated side. Clinicians should be cautious that the unaffected joint in BS may serve an important role in altered lumbopelvic biomechanism, since it might eventually lead to intractable chronic LBP when overlooked.

• Proceedings of the KSMRM Conference
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• 2007.10a
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• pp.39-39
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• 2007

• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.125-131
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• 2022

This study was to investigate the effectiveness of combined Korean medicine treatment on a patient who was diagnosed on lumbosacral transitional vertebra (LSTV) with localized bone marrow edema. The patient was treated with acupuncture, pharmacopucture, cupping and herbal medicine. We evaluated patient's progress using range of motion (ROM), EuroQol-5 dimensions (EQ-5D), Oswestry disability index (ODI), numerical rating scale (NRS), patient global impression of change, self-walkable distance. NRS of back pain decreased from 7 to 5, at the same time NRS of lower limb decreased from 4 to 3. EQ-5D score increased from 0.24 to 0.646. ODI score improved 80 to 62. Self-walkable distance and lumbar spine ROM also increased. As a result, clinical improvements were found in a patient. In conclusion, this study shows that Korean medicine treatment can be considered as effective conservative care for LSTV with localized bone marrow edema.

• Journal of Veterinary Science
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• v.22 no.4
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• pp.52.1-52.8
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• 2021

Background: The normal vertebral anatomy of Korean raccoon dogs and their variants require research attention as a prerequisite for identifying pathologies and anomalies. Objectives: This retrospective study aimed at describing the vertebral formula and congenital vertebral anomalies in Korean raccoon dogs (Nyctereutes procyonoides koreensis). Methods: Radiographs of 82 raccoon dogs (42 males, 40 females) acquired from May 2013 to June 2020 in the Gangwon Wildlife Medical Rescue Center were reviewed to evaluate the cervical, thoracic, and lumbar vertebrae of the spine. Results: Normal morphology of all vertebrae was observed in 50 of the 82 raccoon dogs, and the vertebral formula was cervical 7, thoracic 13, and lumbar 7. Congenital vertebral anomalies were found in 32 raccoon dogs: transitional vertebrae (TV) in 31 and block vertebrae in 2. Two raccoon dogs had 2 types of vertebral anomalies: one had TV and block vertebra, and the other had 2 types of TV. Twenty-nine raccoon dogs had thoracolumbar TV (TTV) and 3 had lumbosacral TV. TTV was morphologically classified into 4 different types: unilateral extra-rib in 5 raccoon dogs, bilateral extra-ribs in 14, bilateral elongated transverse processes in 4, and an asymmetric mixed formation of extra-rib with elongated transverse process in 6. Conclusions: This study showed that TTV is common in Korean raccoon dogs, and that the vertebral formula is relatively diverse. The bilateral extra-ribs type TTV is the most common variant, which is almost similar to normal rib to be confused the radiographic evaluation.

• The Korean Journal of Pain
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• v.26 no.4
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• pp.368-373
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• 2013

Background: Bertolotti's syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS. Methods: All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief. Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.203-210
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• 2021

Bertolotti's syndrome is a rare spinal disease and it is known to cause low back pain due to a lumbosacral transitional vertebra. There has been rare study of Bertolotti's syndrome. This study reports the effects of Korean medicine treatment on the patient who was diagnosed on Bertolotti's syndrome. The patient was treated with Korean medicine treatment including acupuncture, pharmacopuncture, herbal medicine, and Chuna manual therapy during 40 days. Numerical rating scale (NRS), Euroqol five dimension (EQ-5D) index, Oswestry disability index (ODI), lumbar range of motion were used for assessment. After treatment, low back pain NRS decreased from 3 to 2, and low limb pain NRS decreased from 5 to 2. EQ-5D index, ODI and lumbar range of motion also were improved. This study shows Korean medicine treatment can be an effective care for Bertolotti's syndrome.