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CASE REPORT
Year : 2012  |  Volume : 1  |  Issue : 4  |  Page : 290-292

Extraordinary bilateral elongation of transverse processes of fifth lumbar vertebra causing severe pain: An unusual and rare variant of Bertolotti's syndrome


1 Department of Orthopaedics, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India
2 Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India
3 Department of Anatomy, Government Medical College, Patiala, Punjab, India

Correspondence Address:
Sukhminder Jit Singh Bajwa
Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, House No-27-A, Ratan Nagar, Tripuri, Patiala, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.107898

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A 53-year-old female presented with an intermittent low back pain above the sacroiliac joints to the orthopedic outpatient department. There was no history of trauma. Clinically, the straight-leg-raising test was negative. There was left paraspinal tenderness just above the sacroiliac joint and a nodular swelling in that area was felt. A plain radiograph was taken, which showed bilateral elongation and fusion of the fifth lumbar transverse process with the iliac crests and was diagnosed as a rare and unusual variant of Bertolotti's syndrome. There was also fusion of body of the fifth lumbar with first sacral vertebra. The patient was advised conservative treatment in the form of rest, medication, ergonomic advice, and local steroid injection in tender nodular area besides epidural administration of methylprednisolone with local anesthetic ropivacaine. The patient got therapeutic relief from the pain associated with lumbosacral pathology after epidural injection of local anesthetic and steroid. The patient was advised magnetic resonance imaging scan for further evaluation so as to plan surgical excision of fused transverse processes.


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