{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:57:20Z","timestamp":1784696240407,"version":"3.55.0"},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,7,21]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Bertolotti\u2019s syndrome (BS) is characterized by anomalous enlargement of the transverse process (TP) of the most caudal lumbar vertebra, which may articulate or fuse with the sacrum or ilium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 69-year-old female presented to the hospital with a chief complaint of right low back pain (LBP) during rolling over, while crouching down, and with prolonged sitting. No obvious neurological abnormality was found. Radiography and CT findings revealed that the right TP of L5 articulated with the iliac bone. The patient\u2019s pain was resistant to conservative treatment with appropriate nonsteroidal anti-inflammatory drugs over a period of approximately 9 months. A local anesthetic injection into the articulated lesion under fluoroscopic guidance led to LBP improvement, but the effect was transient. Full endoscopic spine surgery (FESS) was performed to reduce the enlargement of the TP articulated with the ilium under fluoroscopy. Postoperative CT revealed the disconnection between the TP at L5 and the ilium. LBP dramatically resolved postoperatively, and the patient was discharged home without any perioperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>FESS may be an effective treatment for patients with LBP due to minimally invasive BS.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25188\">https:\/\/thejns.org\/doi\/10.3171\/CASE25188<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25188","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T23:37:17Z","timestamp":1753141037000},"source":"Crossref","is-referenced-by-count":4,"title":["Minimally invasive full endoscopic resection of the anomalous transverse process in Bertolotti\u2019s syndrome: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7170-4564","authenticated-orcid":true,"given":"Toshinari","family":"Kawasaki","sequence":"first","affiliation":[{"name":"Department of Spinal Neurosurgery, Kyoto Katsura Hospital, Kyoto, Japan"},{"name":"Department of Neurosurgery, Hikone Chuo Hospital, Hikone, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6764-3284","authenticated-orcid":true,"given":"Yoshinori","family":"Maki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hikone Chuo Hospital, Hikone, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Ioroi","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery, Kyoto Katsura Hospital, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamaki","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery, Kyoto Katsura Hospital, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motohiro","family":"Takayama","sequence":"additional","affiliation":[{"name":"Department of Spinal Neurosurgery, Kyoto Katsura Hospital, Kyoto, Japan"},{"name":"Department of Neurosurgery, Hikone Chuo Hospital, Hikone, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"bib1","series-title":"Radiol Med","first-page":"113","article-title":"Contributo alla conoscenza dei vizi di differenziazione regionale del rachide con special riguardo all assimilazione sacral della V","volume":"4","author":"Bertolotti","year":"1917","unstructured":"Bertolotti M.Contributo alla conoscenza dei vizi di differenziazione regionale del rachide con special riguardo all assimilazione sacral della V. Radiol Med. 1917;4:113-144."},{"issue":"2","key":"bib2","series-title":"Spine","first-page":"226","article-title":"Partial lumbosacral transitional vertebra resection for contralateral facetogenic pain","volume":"26","author":"Brault","year":"2001","unstructured":"Brault JSSmith JCurrier BL.Partial lumbosacral transitional vertebra resection for contralateral facetogenic pain. Spine. 2001;26(2):226-229."},{"issue":"3","key":"bib3","series-title":"J Neurosurg Spine","first-page":"283","article-title":"Minimally invasive tubular resection of the anomalous transverse process in patients with Bertolotti\u2019s syndrome: presented at the 2013 Joint Spine Section Meeting: Clinical article","volume":"20","author":"Li","year":"2014","unstructured":"Li YLubelski DAbdullah KGMroz TESteinmetz MP.Minimally invasive tubular resection of the anomalous transverse process in patients with Bertolotti\u2019s syndrome: presented at the 2013 Joint Spine Section Meeting: Clinical article. J Neurosurg Spine. 2014;20(3):283-290."},{"issue":"8","key":"bib4","series-title":"Spine J","first-page":"1286","article-title":"Clinical assessment and management of Bertolotti Syndrome: a review of the literature","volume":"21","author":"McGrath","year":"2021","unstructured":"McGrath KSchmidt ERabah NAbubakr MSteinmetz M.Clinical assessment and management of Bertolotti Syndrome: a review of the literature. Spine J. 2021;21(8):1286-1296."},{"issue":"2","key":"bib5","series-title":"Arch Orthop Trauma Surg","first-page":"82","article-title":"Surgical treatment of Bertolotti\u2019s syndrome: follow-up of 16 patients","volume":"112","author":"Santavirta","year":"1993","unstructured":"Santavirta STallroth KYlinen PSuoranta H.Surgical treatment of Bertolotti\u2019s syndrome: follow-up of 16 patients. Arch Orthop Trauma Surg. 1993;112(2):82-87."},{"issue":"5","key":"bib6","series-title":"Spine","first-page":"493","article-title":"Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects","volume":"9","author":"Castellvi","year":"1984","unstructured":"Castellvi AEGoldstein LAChan DPK.Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. Spine. 1984;9(5):493-495."},{"issue":"1","key":"bib7","series-title":"Pain Physician","first-page":"53","article-title":"Lumbosacral transitional vertebrae: incidence in a consecutive patient series","volume":"9","author":"Delport","year":"2006","unstructured":"Delport EGCucuzzella TRKim NMarley JPruitt CDelport AG.Lumbosacral transitional vertebrae: incidence in a consecutive patient series. Pain Physician. 2006;9(1):53-56."},{"issue":"3","key":"bib8","series-title":"Rheumatol Rehabil","first-page":"180","article-title":"The transitional vertebra of the lumbosacral spine: its radiological classification, incidence, prevalence, and clinical significance","volume":"16","author":"Tini","year":"1977","unstructured":"Tini PGWieser CZinn WM.The transitional vertebra of the lumbosacral spine: its radiological classification, incidence, prevalence, and clinical significance. Rheumatol Rehabil. 1977;16(3):180-185."},{"issue":"2","key":"bib9","series-title":"Radiology","first-page":"497","article-title":"Lumbosacral transitional vertebrae: association with low back pain","volume":"265","author":"Nardo","year":"2012","unstructured":"Nardo LAlizai HVirayavanich WLumbosacral transitional vertebrae: association with low back pain. Radiology. 2012;265(2):497-503."},{"issue":"2","key":"bib10","series-title":"Spine","first-page":"200","article-title":"Lumbosacral transitional vertebra: relation to disc degeneration and low back pain","volume":"29","author":"Luoma","year":"2004","unstructured":"Luoma KVehmas TRaininko RLuukkonen RRiihim\u00e4ki H.Lumbosacral transitional vertebra: relation to disc degeneration and low back pain. Spine. 2004;29(2):200-205."},{"issue":"6","key":"bib11","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"566","article-title":"Percutaneous full endoscopic treatment of Bertolotti syndrome: a report of three cases with technical note","volume":"78","author":"Paudel","year":"2017","unstructured":"Paudel BKim HSJang JSPercutaneous full endoscopic treatment of Bertolotti syndrome: a report of three cases with technical note. J Neurol Surg A Cent Eur Neurosurg. 2017;78(6):566-571."},{"issue":"1","key":"bib12","series-title":"Cureus","first-page":"e33397","article-title":"Endoscopic resection of pseudoarticulation as a treatment for Bertolotti\u2019s syndrome","volume":"15","author":"Stein","year":"2023","unstructured":"Stein EPanjeton GDKumar S.Endoscopic resection of pseudoarticulation as a treatment for Bertolotti\u2019s syndrome. Cureus. 2023;15(1):e33397."},{"issue":"10","key":"bib13","series-title":"Acta Neurochir (Wien)","first-page":"2789","article-title":"How I do it? Uniportal full endoscopic pseudoarthrosis release of left L5\/S1 Bertolotti\u2019s syndrome under intraoperative computer tomographic guidance in an ambulatory setting","volume":"163","author":"Wu","year":"2021","unstructured":"Wu PHSebastian MKim HSHeng GTY.How I do it? Uniportal full endoscopic pseudoarthrosis release of left L5\/S1 Bertolotti\u2019s syndrome under intraoperative computer tomographic guidance in an ambulatory setting. Acta Neurochir (Wien). 2021;163(10):2789-2795."},{"key":"bib1","series-title":"Radiol Med","first-page":"113","article-title":"Contributo alla conoscenza dei vizi di differenziazione regionale del rachide con special riguardo all assimilazione sacral della V","volume":"4","author":"Bertolotti","year":"1917","unstructured":"Bertolotti M.Contributo alla conoscenza dei vizi di differenziazione regionale del rachide con special riguardo all assimilazione sacral della V. Radiol Med. 1917;4:113-144."},{"issue":"2","key":"bib2","series-title":"Spine","first-page":"226","article-title":"Partial lumbosacral transitional vertebra resection for contralateral facetogenic pain","volume":"26","author":"Brault","year":"2001","unstructured":"Brault JSSmith JCurrier BL.Partial lumbosacral transitional vertebra resection for contralateral facetogenic pain. Spine. 2001;26(2):226-229."},{"issue":"3","key":"bib3","series-title":"J Neurosurg Spine","first-page":"283","article-title":"Minimally invasive tubular resection of the anomalous transverse process in patients with Bertolotti\u2019s syndrome: presented at the 2013 Joint Spine Section Meeting: Clinical article","volume":"20","author":"Li","year":"2014","unstructured":"Li YLubelski DAbdullah KGMroz TESteinmetz MP.Minimally invasive tubular resection of the anomalous transverse process in patients with Bertolotti\u2019s syndrome: presented at the 2013 Joint Spine Section Meeting: Clinical article. J Neurosurg Spine. 2014;20(3):283-290."},{"issue":"8","key":"bib4","series-title":"Spine J","first-page":"1286","article-title":"Clinical assessment and management of Bertolotti Syndrome: a review of the literature","volume":"21","author":"McGrath","year":"2021","unstructured":"McGrath KSchmidt ERabah NAbubakr MSteinmetz M.Clinical assessment and management of Bertolotti Syndrome: a review of the literature. Spine J. 2021;21(8):1286-1296."},{"issue":"2","key":"bib5","series-title":"Arch Orthop Trauma Surg","first-page":"82","article-title":"Surgical treatment of Bertolotti\u2019s syndrome: follow-up of 16 patients","volume":"112","author":"Santavirta","year":"1993","unstructured":"Santavirta STallroth KYlinen PSuoranta H.Surgical treatment of Bertolotti\u2019s syndrome: follow-up of 16 patients. Arch Orthop Trauma Surg. 1993;112(2):82-87."},{"issue":"5","key":"bib6","series-title":"Spine","first-page":"493","article-title":"Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects","volume":"9","author":"Castellvi","year":"1984","unstructured":"Castellvi AEGoldstein LAChan DPK.Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. Spine. 1984;9(5):493-495."},{"issue":"1","key":"bib7","series-title":"Pain Physician","first-page":"53","article-title":"Lumbosacral transitional vertebrae: incidence in a consecutive patient series","volume":"9","author":"Delport","year":"2006","unstructured":"Delport EGCucuzzella TRKim NMarley JPruitt CDelport AG.Lumbosacral transitional vertebrae: incidence in a consecutive patient series. Pain Physician. 2006;9(1):53-56."},{"issue":"3","key":"bib8","series-title":"Rheumatol Rehabil","first-page":"180","article-title":"The transitional vertebra of the lumbosacral spine: its radiological classification, incidence, prevalence, and clinical significance","volume":"16","author":"Tini","year":"1977","unstructured":"Tini PGWieser CZinn WM.The transitional vertebra of the lumbosacral spine: its radiological classification, incidence, prevalence, and clinical significance. Rheumatol Rehabil. 1977;16(3):180-185."},{"issue":"2","key":"bib9","series-title":"Radiology","first-page":"497","article-title":"Lumbosacral transitional vertebrae: association with low back pain","volume":"265","author":"Nardo","year":"2012","unstructured":"Nardo LAlizai HVirayavanich WLumbosacral transitional vertebrae: association with low back pain. Radiology. 2012;265(2):497-503."},{"issue":"2","key":"bib10","series-title":"Spine","first-page":"200","article-title":"Lumbosacral transitional vertebra: relation to disc degeneration and low back pain","volume":"29","author":"Luoma","year":"2004","unstructured":"Luoma KVehmas TRaininko RLuukkonen RRiihim\u00e4ki H.Lumbosacral transitional vertebra: relation to disc degeneration and low back pain. Spine. 2004;29(2):200-205."},{"issue":"6","key":"bib11","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"566","article-title":"Percutaneous full endoscopic treatment of Bertolotti syndrome: a report of three cases with technical note","volume":"78","author":"Paudel","year":"2017","unstructured":"Paudel BKim HSJang JSPercutaneous full endoscopic treatment of Bertolotti syndrome: a report of three cases with technical note. J Neurol Surg A Cent Eur Neurosurg. 2017;78(6):566-571."},{"issue":"1","key":"bib12","series-title":"Cureus","first-page":"e33397","article-title":"Endoscopic resection of pseudoarticulation as a treatment for Bertolotti\u2019s syndrome","volume":"15","author":"Stein","year":"2023","unstructured":"Stein EPanjeton GDKumar S.Endoscopic resection of pseudoarticulation as a treatment for Bertolotti\u2019s syndrome. Cureus. 2023;15(1):e33397."},{"issue":"10","key":"bib13","series-title":"Acta Neurochir (Wien)","first-page":"2789","article-title":"How I do it? Uniportal full endoscopic pseudoarthrosis release of left L5\/S1 Bertolotti\u2019s syndrome under intraoperative computer tomographic guidance in an ambulatory setting","volume":"163","author":"Wu","year":"2021","unstructured":"Wu PHSebastian MKim HSHeng GTY.How I do it? Uniportal full endoscopic pseudoarthrosis release of left L5\/S1 Bertolotti\u2019s syndrome under intraoperative computer tomographic guidance in an ambulatory setting. Acta Neurochir (Wien). 2021;163(10):2789-2795."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/3\/article-CASE25188.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/3\/article-CASE25188.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/10\/3\/article-CASE25188.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T11:09:11Z","timestamp":1769684951000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/10\/3\/article-CASE25188.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,21]]},"references-count":26,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/case25188","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,21]]}}}