Sacralization of the L5 vertebra (Bertolotti syndrome): literature review

Abstract

Introduction The resultant cause of pain syndrome in the lumbosacral spine in the contemporary population are dysplasia and anomalies of the development of vertebral segments, among which the sacralization of the L5 vertebra (Bertolotti syndrome) is often diagnosed. In the domestic medical literature, few publications on this pathology have been found. Methods Scientific studies for this literature review were obtained from PubMed, eLIBRARY, CYBERLENINNKA. Eighty scientific articles were used. The search for literature sources was carried out with the following keywords: sacralization of the L5 vertebra, Bertolotti Syndrome. Results and discussion In the course of the analysis, it was established that the rate of diagnosis of sacralization of the L5 vertebra ranges from 4 to 36 % of cases. It is equally detected among males and females. This pathology is frequently found in children and adolescents. Pain in the lumbar spine and sacrum is the leading clinical symptom of the disease. The severity of pain on the visual analogue scale mainly corresponds to 5 points. Scoliosis, spondylolistesis, herniated disks, spina bifida posterior may exacerbate the clinical symptoms of the associated sacralization of the L5 vertebra. During the examination of patients, plain radiography, computed tomography and magnetic resonance imaging are used. Cases of sacralization of the L5 vertebra are divided into 7 types, according to the classification of A.E. Castellvi et al. (1984). Treatment of vertebrogenic pain syndrome is carried out both conservatively (drug therapy, therapeutic blockades) and surgically (resection of the L5 transverse process, decompression of the stenotic intervertebral foramina, transpedicular fusion, radiofrequency ablation).