Features of clinical manifestations, diagnosis and treatment of Bertolotti syndrome: а clinical case
- Authors: Sklyarenko O.V.1, Larionov S.N.2, Zhivotenko A.P.2, Potapov V.E.1, Gorbunov A.V.1
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Affiliations:
- Irkutsk Scientific Center of Surgery and Traumatology
- Irkutsk Scientific Centre of Surgery and Traumatology
- Issue: Vol 15, No 2 (2024)
- Pages: 89-97
- Section: Case reports
- URL: https://journals.rcsi.science/clinpractice/article/view/262733
- DOI: https://doi.org/10.17816/clinpract629406
- ID: 262733
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Abstract
BACKGROUND: One of the causes of pain in the lumbar spine may be congenital spinal column malformations. Bertolotti syndrome is a clinical and radiological symptom complex associated with sacralization of the LV vertebra, leading to disruption of the biomechanics of the lumbosacral spine and accelerated degeneration of facet joints and intervertebral discs, followed by foraminal and central stenosis of the spinal canal. The clinical manifestations of the disease can be polymorphic, and their cause is multifactorial. Thus, along with pain in the lumbar spine, patients with sacralization of the LV vertebra suffer from numbness and paresthesia in the lower extremities. The incidence of pathology ranges from 4% to 8%, mainly affecting elderly and mature people.
СLINICAL CASE DESCRIPTION: Patient S was born in 1982 with long-term nonspecific pain in the back and lower limb; she presented to the Neurosurgical Department of the Irkutsk Scientific Center for Surgery and Traumatology. During a clinical neurological examination and additional introscopic studies of the lumbar spine, dorsopathy diagnosed. Degenerative spondyloarthrosis LIV–LV grade III according to D. Weishaupt. Sacralization of the LV vertebra type IIa according to Castellvi A.E. Syndrome of lumbar ischialgia on the right. Persistent pain and muscle-tonic syndrome. Minimally invasive interventional treatment was performed: pulsed radiofrequency ablation of the dorsal ganglion and radicular nerve at the level of the foraminal openings LIV–LV on the right and thermal radiofrequency ablation of the recurrent nerve of Luschka at the level of LIV–LV and LV–SI on the right. In the postoperative period, the intensity of the pain syndrome decreased, and the patient was discharged to work.
CONCLUSION: A promising method of minimally invasive surgery is radiofrequency ablation in the area of neoarthrosis for denervation and relief of pathological pain impulses. Assessing the patient’s complaints, carefully collecting anamnesis, interpreting data from a clinical and neurological examination, and introscopic methods of examining the lumbar spine enables establishing an accurate diagnosis and selecting the most effective treatment method.
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##article.viewOnOriginalSite##About the authors
Oxana V. Sklyarenko
Irkutsk Scientific Center of Surgery and Traumatology
Email: oxanasklyarenko@mail.ru
ORCID iD: 0000-0003-1077-7369
SPIN-code: 7884-9030
MD, PhD
Russian Federation, IrkutskSergey N. Larionov
Irkutsk Scientific Centre of Surgery and Traumatology
Email: snlar@mail.ru
ORCID iD: 0000-0001-9189-3323
SPIN-code: 6720-4117
MD, PhD, Professor
Russian Federation, IrkutskAlexandr P. Zhivotenko
Irkutsk Scientific Centre of Surgery and Traumatology
Author for correspondence.
Email: sivotenko1976@mail.ru
ORCID iD: 0000-0002-4032-8575
SPIN-code: 8016-5626
Junior Research Associate
Russian Federation, IrkutskVitaly E. Potapov
Irkutsk Scientific Center of Surgery and Traumatology
Email: pva454@yandex.ru
ORCID iD: 0000-0001-9167-637X
SPIN-code: 5349-8690
MD, PhD
Russian Federation, IrkutskAnatoly V. Gorbunov
Irkutsk Scientific Center of Surgery and Traumatology
Email: a.v.gorbunov58@mail.ru
ORCID iD: 0000-0002-1352-0502
SPIN-code: 6329-2590
Junior Research Associate
Russian Federation, IrkutskReferences
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