Frontiers in surgery · 2026
Unilateral biportal endoscopic spinal surgery for the treatment of Bertolotti syndrome in an adolescent, a case report.
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Ren L, Qiao T, Zhang Y, Wang Y, Zhang X
Аннотация
BACKGROUND: Bertolotti syndrome (BS), associated with lumbosacral transitional vertebrae (LSTVs), is characterized by back pain and/or radicular symptoms due to the compression of the fifth lumbar (L5) exiting nerve roots. The surgical treatment of BS by partial resection of L5 transverse process (TP) or sacral alar via diverse techniques achieves encouraging clinical results. However, related reports on endoscopic surgery for adolescent patients with BS are rare. We here present a case of a 17-year young girl with BS who underwent endoscopic resection of left side L5/S1 pseudoarthrosis by using a unilateral biportal endoscopic spinal surgery (UBESS, UBE) technique.
METHODS: The current study presented a 17-year-old high-school girl who suffered from 4 months persistent lower back pain (LBP) at her first visit to our hospital. After 3 months conservative treatment, the young girl presented a severe back pain combined with left radicular pain for 1.5 months. Preoperative imaging revealed an obviously LSTV (type of Castellvi IIa) and a left side L5/S1 pseudoarthrosis. After carefully preoperative preparation and a diagnostic anesthetic block, the patient accepted an endoscopic decompression surgery via a UBE technique. During the surgery, the left hypertrophic L5 TP as well as the sacral alar were partially resected and the L5 nerve root was decompressed.
RESULTS: Under the intraoperative endoscopic view, the left L5/S1 pseudoarthrosis was removed by using a high-speed bur. And the left L5 nerve root was perfectly decompressed without vice injury. The lower back pain and radicular pain were greatly relieved on the next postoperative day after the minimally invasive spinal surgery. The visual analogue scale (VAS) back pain score was improved from 8 points preoperative to 2 points postoperative, while the leg pain score was improved from 8 points preoperative to 1 points postoperative. The symptoms of back pain and radiculopathy were thoroughly vanished at the 3-month follow-up. And the patient never returned back to our clinic for further medical consultation.
CONCLUSION: Endoscopic decompression via an UBE technique can be an effective choice for adolescent patients with BS after failed conservative therapy.
METHODS: The current study presented a 17-year-old high-school girl who suffered from 4 months persistent lower back pain (LBP) at her first visit to our hospital. After 3 months conservative treatment, the young girl presented a severe back pain combined with left radicular pain for 1.5 months. Preoperative imaging revealed an obviously LSTV (type of Castellvi IIa) and a left side L5/S1 pseudoarthrosis. After carefully preoperative preparation and a diagnostic anesthetic block, the patient accepted an endoscopic decompression surgery via a UBE technique. During the surgery, the left hypertrophic L5 TP as well as the sacral alar were partially resected and the L5 nerve root was decompressed.
RESULTS: Under the intraoperative endoscopic view, the left L5/S1 pseudoarthrosis was removed by using a high-speed bur. And the left L5 nerve root was perfectly decompressed without vice injury. The lower back pain and radicular pain were greatly relieved on the next postoperative day after the minimally invasive spinal surgery. The visual analogue scale (VAS) back pain score was improved from 8 points preoperative to 2 points postoperative, while the leg pain score was improved from 8 points preoperative to 1 points postoperative. The symptoms of back pain and radiculopathy were thoroughly vanished at the 3-month follow-up. And the patient never returned back to our clinic for further medical consultation.
CONCLUSION: Endoscopic decompression via an UBE technique can be an effective choice for adolescent patients with BS after failed conservative therapy.