A Case Reports of Intra-Articular Steroid Injection in the Treatment of Bertolotti’s Syndrome

Abstract

Bertolotti’s Syndrome (BS) is defined as an association between low back pain (LBP) and the congenital malformation of the lumbosacral transitional vertebra (LSTV). There are several treatments have been proposed by literature including steroid injections, resections of the LSTV, laminectomy, and lumbar spinal fusion, however, there is no best treatment has been agreed. Researchers present three case reports diagnosed as BS in Malaysia age from 25 to 30 years with chronic low back pain extending to the gluteal region and just above the ipsilateral sacroiliac joint. Radiographic investigation of these three patients revealed an anomalous enlargement of the left, right and bilateral transverse process of the fifth lumbar (L5) vertebra forming a pseudoarthrosis with the infra adjacent ala of the sacrum. These cases were managed successfully with fluoroscopically guided intra-articular steroid injection with local anaesthetic over the transverse process with ilium articulation and asymptomatic for 6 months on follow up. This case report denoted that a simple non-surgical management for treating symptomatic lumbosacral junction pseudo-articulation that warrants a better mode of management.