Treatment Approaches for Bertolotti Syndrome

Bertolotti综合征指的是因腰骶移行椎横突单侧或双侧异常增大所导致的一系列症状与体征，患者常表现出腰骶部疼痛及下肢放射痛等，该病在临床上发病率较低，常被误诊。一般采用X线检查对Bertolotti综合征进行诊断，不过随着技术的进步，多层螺旋CT的多平面重建与容积再现技术在诊断Bertolotti综合征中展现出显著优势。对于Bertolotti综合征，传统的治疗手段如药物镇痛及局部阻滞等在实际应用中效果有限，现阶段手术治疗则涵盖肥大横突切除术、融合术及单侧双通道内镜下的神经根管减压术等，均具有较好的效果。不过部分手术创伤大、并发症多、复发率高，而椎间盘镜手术、单侧双通道内镜下神经根管减压术以及联合疗法成为治疗Bertolotti综合征的更优选择。Bertolotti syndrome refers to a series of symptoms and signs caused by unilateral or bilateral abnormal enlargement of the transverse processes of the lumbosacral transitional vertebra. Patients often present with lumbosacral pain and radiating pain in the lower limbs. The disease has a relatively low clinical incidence and is frequently misdiagnosed. X-ray examination is generally used for the diagnosis of Bertolotti syndrome. However, with technological advancements, multiplanar reconstruction and volume rendering techniques of multi-slice spiral CT have demonstrated significant advantages in diagnosing Bertolotti syndrome. For Bertolotti syndrome, traditional treatment methods such as pharmacological analgesia and local nerve blocks have limited efficacy in practical applications. At present, surgical treatments, including resection of the enlarged transverse process, fusion surgery, and unilateral biportal endoscopic nerve root canal decompression, have shown favorable outcomes. Nevertheless, some surgical procedures are associated with significant trauma, a high incidence of complications, and a high recurrence rate. Consequently, procedures such as microendoscopic discectomy, unilateral biportal endoscopic nerve root canal decompression, and combination therapies have emerged as superior options for treating Bertolotti syndrome.