The most important indication is that all other potential pain generators are ruled out. If all are ruled out, then the MRI must support Bertolotti’s syndrome as a pain generator (high bone signal on STIR images). Then, a diagnostic pain block of the articulation is necessary.
Finally, a resection or fusion is considered. If the transverse-alar articulation is small, a resection is considered. However, a resection should remove the painful articulation but there are still painful patients that present to me as a second opinion after this articulation is removed. A fusion seems to be the answer so I tend to go directly to the fusion first.
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.
