Bartolotti Syndrome

///Bartolotti Syndrome
Bartolotti Syndrome
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  • Lissa
    Participant
    Post count: 1

    Hello, I have episodic crisis back pain every 3 months or so. Pain is in lower lumbar excruciating, sharp, stabbing pain in my left buttocks, radiating into my leg. During the terrible 1st 3 or 4 days, i can barely walk. Hurts at a 9 or 10 to walk, definitely a 10 from sitting to standing, standing to sitting and walking up and down stairs. I often describe the pain as if someone is pushing up on my hips and down on my sacrum at the same time. Pain in lower mid back is 7 or 8. It was observed by my chiropractor in 2017 that i have a 6th vertebrae and confirmed by my pcp a week ago. My back pain began in 2006, at 27 yrs old. I’m now 39 and been hospitalized one time due to collapse at work. That time i was told of bulging discs in l4 l5 but mild. They administered multiple pain meds, none worked except the epidural steroid, which was effective for 5 years…or jan 2019. It’s back. No diagnosis. I had the x ray in 2017, as i attempted to see a reg chiropractor which my insurance quickly denied in jan 2018. My pcp informed me i have protruding l4 and l5 disc mildly compressing nerves and s1 bulge too. Mild neuro formanial stenosis also. I cant help but feel this is due to my 6th vertebrae. I have not seen the xrays or mri but would like to. They recommend physical therapy. I asked 4 an epidural flood which they did schedule. How can u tell if it is bertolotti? Why is this a commonly missed diagnosis? Could this be whats going on?

    Donald Corenman, MD, DC
    Moderator
    Post count: 6700

    You should not be too hard to diagnose. Bertolotti’s syndrome is extremely rare even if you have a large transverse-alar articulation. It is initially suspected by looking at the MRI using the inflammation (STIR) images. If there is reactive bone (bone that lights up on the STIR images), then Bertolotti’s syndrome is possible. You should then get an anesthetic injection in this pseudo-joint and get three hours of great relief. If you pass all these tests, then you do have Bertolotti’s syndrome. Either a fusion (more predictable relief) or an excision of the transverse-alar articulation would be called for. However, I predict that your symptoms are probably not this syndrome. You need an expert to look at you and determine what is causing your pain.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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