Bertolotti's Syndrome Requiring Intervention for Lower Back Pain: Two Cases Suspected as Ankylosing Spondylitis

Abstract

Bertolotti's syndrome is the part of lumbosacral transitional vertebra and is a congenital anomaly of the axial spine. The syndrome is associated with changes in the sacrum or iliac crest and secondary arthritis and is often mistaken for ankylosing spondylitis (AS). The mechanism of pain in this disease is unclear, and treatments have not been accurately established. Here, we report two cases of Bertolotti's syndrome in patients with severe back pain who were initially suspected to have AS and required interventional procedures. The two young adult patients developed symptoms similar to those of inflammatory back pain, and their symptoms did not improve with conventional treatment alone. Both patients underwent interventional management, and the symptoms improved. It may be clinically helpful to confirm the presence of Bertolotti's syndrome in patients with suspected AS, and interventional therapy may be required in some cases.