Advances in Chinese and Western Diagnosis and Treatment of Bertolotti Syndrome
DOI:
https://doi.org/10.53469/jcmp.2025.07(03).39Keywords:
Lumbosacral migratory vertebrae, Low back pain, Pseudoarthrosis, Chinese and Western medical treatment, Imaging diagnosisAbstract
Bertolotti syndrome (BS), also known as fifth lumbar transverse process hypertrophy syndrome, is a clinical syndrome characterized by lumbosacral translocated vertebrae (LSTV), and is a relatively rare but easily overlooked chronic lower back pain condition. As a relatively rare but easily overlooked structural disorder, BS has long been categorized as "nonspecific lower back pain" in clinical practice. Nowadays, people's attention to lumbosacral migratory vertebrae causing low back pain has been increased, and the diagnosis and treatment of BS have been reported to be increasing in the international literature year by year. Through reviewing the relevant literature at home and abroad in recent years, the author found that Western medicine has made more in-depth research on the imaging and surgical interventions of BS, but lacks breakthrough treatments for the recurring lumbar pain, whereas traditional Chinese medicine has achieved certain clinical efficacy through the combination of traditional Chinese medicine, acupuncture, and massage. Traditional Chinese medicine (TCM) has achieved certain clinical efficacy through a combination of traditional Chinese medicine, acupuncture, tuina and other means, but more research is needed on the material basis and mechanism of its effect. However, more research is needed on the material basis of its effect and its mechanism of action. The combination of Chinese and Western medicine shows unique advantages in precise localization of lesions and improvement of pain and function, which is worthy of further in-depth study. In this paper, we review the Chinese and Western medicine diagnosis and treatment of BS, aiming to provide new ideas and methods for the diagnosis and treatment of BS.
References
Tins, Bernhard J., and Birender Balain. "Incidence of numerical variants and transitional lumbosacral vertebrae on whole-spine MRI. "Insights into imaging 7 (2016): 199-203.
Tins Bernhard J, Balain Birender,. Incidence of numerical variants and transitional lumbosacral vertebrae on whole-spine MRI. [J]. Insights into imaging, 2016, 7(2):199-203.
Adams, Ryan, Sarah Herrera-Nicol, and Arthur L. Jenkins III. "Surgical treatment of a rare presentation of Bertolotti's syndrome from Castellvi type IV lumbosacral transitional vertebra: case report and review of the literature." Journal of neurological surgery reports 79.03 (2018): e70-e74.
Miller, Amanda E. and Andrew Zhang. "Bertolotti Syndrome." StatPearls, StatPearls Publishing, 25 July 2023.
Zhu, Tongxin, et al. "Biomechanical influence of numerical variants of lumbosacral transitional vertebra with Castellvi type I on adjacent discs and facet joints based on 3D finite element analysis." Bone Reports (2025): 101831.
Cho, Sohyun, et al. "Integrative Korean medicine treatment for low back pain with radiculopathy caused by Bertolotti syndrome: a CARE-compliant article and retrospective review of medical records." Medicine 103.37 (2024): e39720.
Sakashita, Kotaro et al. "The association between variations in the number of thoracic and lumbar vertebrae and rib morphology in adolescent idiopathic scoliosis." Spine deformity vol. 12,5 (2024): 1329-1336.
Rakauskas, Taylor R., et al. "An update on the prevalence and management of Bertolotti's syndrome." Frontiers in Surgery 11 (2024): 1486811.
Hanhivaara, Jaakko, et al. "Castellvi classification of lumbosacral transitional vertebrae: comparison between conventional radiography, CT, and MRI." Acta Radiologica 65.12 (2024): 1515-1520.
Crane, Joshua, et al. "A comprehensive update of the treatment and management of Bertolotti's syndrome: a best practices review." Orthopedic Reviews 13.2 (2021): 24980.
Alonzo, Francisco, et al. "Bertolotti's syndrome: an underdiagnosed cause for lower back pain. "Journal of surgical case reports 2018.10 (2018): rjy276.
Bari, Saarim, Varun Menon, and Shankar Bhuvanesh. "Oral pharmacological management of Bertolotti syndrome presenting as chronic low back pain -A case report and review of literature." Journal of Orthopaedics 62 (2025): 122-125.
Zhang, Rui, and Jianguo Cheng. "Interventional Management of Chronic Low Back Pain Associated with Bertolotti's Syndrome: Report of Case Series." Ann Clin Case Rep. 2017; 2 1348 (2017).
Vu, Peter D., et al. "Techniques in medicine: ipsilateral transforaminal epidural steroid injection in Bertolotti's syndrome." Pain Management 14.3 (2024): 125-128.
Solankee J, Sumayo R, Annaswamy T M. Strategies for combining interventional and behavioral therapies in management of chronic low back pain: a scoping review [J]. Interventional Pain Medicine, 2025, 4(1).
Holm E K, Bünger, Cody, Foldager C B. Symptomatic lumbosacral transitional vertebra: a review of the current literature and clinical outcomes following steroid injection or surgical intervention[J]. SICOT-J, 2017, 3:71.
Ju, Chang Il et al. "Decompressive L5 Transverse Processectomy for Bertolotti's Syndrome: A Preliminary Study." Pain physician vol. 20,6 (2017): e923-e932.
YI Meng, DING Li-xiang, SONG Ji-peng, et al. Clinical manifestations and treatment of far-out syndrome [J]. Orthopedic Journal of China.2023,31( 22):2056-2061.
Masaki Tatsumura, Tokio Kawamura, Ayako Uchida, et al. A Case of Endoscopic Partial Transverse Process and Sacral Alar Resection for Bertolotti's Syndrome and Continued Basketball Playing Two Years After Surgery. [J]. Cureus, 2024, 16(6):e62182.
Chung Richard J, Harvie Camryn, O'Donnell John, et al. Surgical outcome of a patient with Bertolotti's syndrome in whom the established Castellvi classification system failed: illustrative case. [J]. Journal of neurosurgery. case lessons, 2023, 5(7).
Stein Eric, Panjeton Geoffrey D, Kumar Sanjeev, et al. Endoscopic Resection of Pseudoarticulation as a Treatment for Bertolotti's Syndrome. [J]. Cureus, 2023, 15(1):e33397-e33397.
Huang Yongxiong, Cheng Xing, Yu Tao, et al. Etiology, diagnosis, and treatment of far out syndrome (FOS): a review and case report [J]. Chinese Journal of Clinical Anatomy,2024,42(6):710-715.
BAI Jian. Research Progress in Treatment of Lumbar Intervertebral Disc Degeneration with Traditional Chinese Medicine. Traditional Chinese Medicine [J], 2021, 48(9):210-212.
CHEN Ming, HAN Tao, ZHU Liguo, et al. Research Progress on the Prevention and Treatment of Low Back Pain with Traditional Chinese and Western Medicine [J]. Western Journal of Traditional Chinese Medicine, 2021, 34(6):153-157.
Wang, Qingchan, et al. "Network pharmacology-based strategy to investigate the pharmacological mechanism of Liuwei Dihuang pill against postmenopausal osteoporosis." Medicine 101.47 (2022): e31387.
Jiang Yanping, Zheng Yongfeng, Dong Qin, et al. Metabolomics combined with network pharmacology to study the mechanism of Shentong Zhuyu decoction Metabolomics combined with network pharmacology to study the mechanism of Shentong Zhuyu decoction in the treatment of rheumatoid arthritis. [J]. Journal of ethnopharmacology, 2021, 285:114846-114846.
Wang, Jir-You, et al. "Du-Huo-Ji-Sheng-Tang and its active component Ligusticum chuanxiong promote osteogenic differentiation and decrease the aging process of human mesenchymal stem cells." Journal of Ethnopharmacology 198 (2017): 64-72.
ZHANG Min, LIANG Feng-ni, SUN Yan-wen, et al. Research progress on chemical constituents, pharmacological effects and clinical application of Eucommia ulmoides ulmoides [J]. Chinese Traditional and Herbal Drugs,2023,54(14):4740-4761.
SONG Jiaming, ZHANG Desheng, Mechanism of inhibiting intervertebral disc annulus fibrosus cell pyroptosis by achyranthes bidentata total saponins through regulating Wnt/β-catenin pathway [J]. Shaanxi Journal of Traditional Chinese Medicine, 2025, 46(03): 325-329.
SHENG Cenzhuo, WANG Yeqing, YAO Xiaocong, et al.S tudy on tonic radix achyranthis bidentatae pill in the treatment of osteoporosis [J]. Chinese Journal of Osteoporosis, 2025,31(1):15-2054
Guan Chao, SHang Qingxin, Research Progress on the Mechanism of Action of Dipsaci Radix and Its Extracts in the Treatment of Osteoarthritis[J]. Jiangsu Journal of Traditional Chinese Medicine,2025,57(03):83-86.
Feng JiuPeng, Kang SiWen, Shang LanQing, et al. Research Progress on the Mechanisms of Drynariae Rhizoma and Dipsaci Radix in the Intervention of Knee Osteoarthritis[J/OL].Journal of Practical Traditional Chinese Internal Medicine,1-7[2025-03-20].
Wang, Min et al. "Electroacupuncture regulates SIRT1/p53/p21 signaling pathway to prevent stress- induced premature senescence of nucleus pulposus cells in degenerative intervertebral discs." International immunopharmacology vol. 148 (2025): 114114. doi:10.1016 /j.intimp.2025.114114
Yunshan, Liang et al. "Integrative research on the mechanisms of acupuncture mechanics and interdisciplinary innovation. " Biomedical engineering online vol. 24,1 30. 7 Mar. 2025, doi:10.1186/ s12938- 025-01357-w
Fan, Zhihong et al. "Clinical efficacy of Tuina therapy combined with traditional Chinese exercises in the treatment of symptomatic lumbar disc herniation: a multicentre randomized controlled trial protocol." Frontiers in neurology vol. 16 1497933. 24 Jan. 2025, doi. 10.3389/fneur.2025.1497933.
ZHANG Yingying, LI Liguo, WU Jie. Effect of Acupuncture and Moxibustion at Five Acupoints Combined with Tuina in Treatment of Lumbago [J]. Liaoning Journal of Traditional Chinese Medicine, 2023, 50(05):218-221.
ZHENG Xi, REN Yongxin, WANG Lina. Effects of needle warming moxibustion combined with massage manipulation on symptoms, pain score and quality of life in patients with Qizhi Xueyu type of low back pain [J]. Shaanxi Journal of Traditional Chinese Medicine, 2019, 40(12):1705-1708.
Zhang, Ping et al. "Quantitative evaluation of microenvironmental changes and efficacy of cupping therapy under different pressures based on photoacoustic imaging." Photoacoustics vol. 40 100661. 30 Oct. 2024.
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