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Case Reports in Orthopedics
Volume 2014, Article ID 613971, 5 pages
Case Report

Minimally Invasive Microendoscopic Resection of the Transverse Process for Treatment of Low Back Pain with Bertolotti’s Syndrome

Department of Orthopedic Surgery, The University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan

Received 20 March 2014; Accepted 30 May 2014; Published 19 June 2014

Academic Editor: Hitesh N. Modi

Copyright © 2014 Yoichiro Takata et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Bertolotti’s syndrome is characterized by anomalous enlargement of the transverse process of the most caudal lumbar segment, causing chronic and persistent low back pain or sciatica. We describe the case of a 45-year-old woman who presented with left sciatic pain and low back pain due to a recurrent lumbar disc herniation at L4-5 with Bertolotti’s syndrome. Selective L5 nerve root block and local injection of lidocaine into the articulation between the transverse process and sacral ala temporarily relieved the left sciatic pain and low back pain, respectively. To confirm the effect of local injection on low back pain, we gave a second local injection, which once again relieved the low back pain. Microendoscopic resection of the pseudoarticulation region and discectomy successfully relieved all symptoms. This report illustrates the effectiveness of minimally invasive resection of the transverse process for the treatment of low back pain with Bertolotti’s syndrome.