Clinical Pain

Korean Association of Pain Medicine (대한임상통증학회)
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Unusual Lower Back Pain on the Non-Articulated Side in Patient with Bertolotti's Syndrome

가관절을 이루고 있지 않은 편측의 통증을 호소한 베르톨로티 증후군

  • Kim, Inah (Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jong In (Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jang, Yongjun (Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Hae-Yeon (Department of Rehabilitation Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea)
  • 김인아 (가톨릭대학교 의과대학 서울성모병원 재활의학과) ;
  • 이종인 (가톨릭대학교 의과대학 서울성모병원 재활의학과) ;
  • 장용준 (가톨릭대학교 의과대학 서울성모병원 재활의학과) ;
  • 박혜연 (가톨릭대학교 의과대학 서울성모병원 재활의학과)
  • Received : 2020.07.21
  • Accepted : 2020.12.07
  • Published : 2021.06.30
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Abstract

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.

Keywords

References

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