Radiofrequency sensory ablation as a treatment for symptomatic unilateral lumbosacral junction pseudarticulation (Bertolotti's syndrome): a case report

Pain Med. 2010 Jun;11(6):853-5. doi: 10.1111/j.1526-4637.2010.00869.x.

Abstract

Objective: Describe the clinical presentation, diagnostic evaluation, and successful treatment of a case of symptomatic unilateral lumbosacral junction pseudarticulation using a novel radiofrequency nerve ablation technique.

Case: A 56-year-old female patient who had suffered with low back and right upper buttock pain for 16 years experienced incomplete relief with L4/5 facet joint radiofrequency ablation. She was found to have an elongated right L5 transverse process that articulated with the sacral ala (Bertolotti's syndrome). Fluoroscopically guided local anesthetic/corticosteroid injection into the pseudarthrosis eliminated her residual right buttock pain for the duration of the local anesthetic only. Complete pain relief was achieved by injecting local anesthetic circumferentially around the posterior pseudarthrosis articular margin. Accordingly, bipolar radiofrequency strip thermal lesions were created at the same locations. Complete pain relief and full restoration of function was achieved for 16 months postprocedure.

Conclusion: This case report describes a novel radiofrequency technique for treating symptomatic lumbosacral junction pseudarticulation that warrants further evaluation.

Publication types

  • Case Reports

MeSH terms

  • Anesthetics, Local / pharmacology
  • Anesthetics, Local / therapeutic use
  • Catheter Ablation / methods*
  • Female
  • Humans
  • Low Back Pain / drug therapy
  • Low Back Pain / etiology
  • Low Back Pain / pathology
  • Low Back Pain / surgery*
  • Lumbar Vertebrae* / pathology
  • Lumbar Vertebrae* / surgery
  • Middle Aged
  • Neurosurgical Procedures / methods*
  • Peripheral Nerves / drug effects
  • Peripheral Nerves / surgery
  • Sacrum* / pathology
  • Sacrum* / surgery
  • Syndrome
  • Treatment Outcome

Substances

  • Anesthetics, Local