Bertolotti Syndrome: A Diagnostic and Management Dilemma for Pain Physicians
0
조회
0
다운로드
7
인용
0
참고문헌
키워드
초록
Background: Bertolotti’s syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS.Methods:All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief.Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.
Abstract
Background: Bertolotti’s syndrome (BS), a form of lumbago in lumbosacral transitional vertebrae, is an important cause of low back pain in young patients. The purpose of this study was to assess the etiology of low back pain and the efficacy of treatment offered to patients with BS.Methods:All patients of BS Castellvi type1a during a period of 6 months were enrolled in the study. The patients underwent interventional pain procedures for diagnosis and pain relief. Response to the therapy was assessed based on VAS and ODI scores. A 50% decrease in VAS score or a VAS score less than 3 would be considered adequate pain relief.Results: All 20 patients diagnosed with BS during the 6-month observation period had scoliosis. Common causes of back pain were the ipsilateral L5-S1 facet joint, neoarticulation, the SI joint, and disc degeneration. Responses to various interventions for pain relief were different and inconsistent from patient to patient. In particular, responses to interventions for neoarticular pain were generally poor. Conclusions: Pain in patients with BS does not usually respond to interventional pain treatment. A very dynamic treatment approach must be pursued while managing BS patients, and the treatment plan must be individualized at various stages in order to obtain satisfactory pain relief.
참고문헌 (8)
- Aihara T, "Intervertebral disc degeneration associated with lumbosacral transitional vertebrae: a clinical and anatomical study", J Bone Joint Surg Br, 87, pp.687~691 (2005)
- Hyun-Seok Tae, "Gray Ramus Communicans Nerve Block : A Useful Therapeutic Adjuvant for Painful Osteoporotic Vertebral Compression Fracture", 대한신경외과학회지, 34(6), pp.505~508 (2003), 대한신경외과학회
- Simopoulos TT, "Radiofrequency lesioning of the L2 ramus communicans in managing discogenic low back pain", Pain Physician, 8, pp.61~65 (2005)
- Manchikanti L, "An algorithmic approach for clinical management of chronic spinal pain", Pain Physician, 12, pp.E225~E264 (2009)
- Henley C, "Sacroiliac pain: a physical therapy perspective", Post-Polio Health, 22, pp.1~3 (2006)
- Marks RC, "Infiltration of anomalous lumbosacral articulations. Steroid and anesthetic injections in 10 back-pain patients", Acta Orthop Scand, 62, pp.139~141 (1991)
- Santavirta S, "Surgical treatment of Bertolotti's syndrome. Follow-up of 16 patients", Arch Orthop Trauma Surg, 112, pp.82~87 (1993)
- Nakamura SI, "The afferent pathways of discogenic low-back pain. Evaluation of L2 spinal nerve infiltration", J Bone Joint Surg Br, 78, pp.606~612 (1996)