Before you assume that Bertolotti’s syndrome is the cause, you need to confirm this diagnosis. This is done with an articular block of the transverse-alar articulation that is the pain generator of this syndrome. If you gain 2-3 hours of relief, this can be confirmed as the pain generator.
Two ways to treat this surgically. One is to remove this articulation. I have performed this twice. One patient did very well and the other had minimal relief. I have fused this segment four times (including the failed resection patient noted above) with good results.
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.