BERTOLOTTI SYNDROME

ABSTRACT Introduction: Lower back disorders are prevalent and a significant reason for emergency care visits. In 2020, 619 million people experienced low back pain, expected to rise to 843 million by 2050. A common cause is the presence of a lumbosacral transitional vertebra (LSTV). Objectives: This study evaluates the prevalence of Bertolotti Syndrome in patients with low back pain in an emergency setting and assesses interobserver reliability of LSTV classifications. Methods: A retrospective analysis of 1023 lumbar spine radiographs from patients presenting with low back pain from 2018 to 2020 was conducted. After exclusions, 469 radiographs were analyzed. Two orthopedists classified LSTVs using Tini and Castellvi's systems. Statistical analyses included the Kappa agreement index, two-proportion Z test, confidence interval for the mean, and p-value calculations. Results: The prevalence of Bertolotti Syndrome was 62.5% for observer A and 61.6% for observer B. Type I LSTV was the most common, with over 70% of cases, followed by type III at over 15%. The most frequent morphology was bilateral involvement of the transverse process, with more than 50% of cases exhibiting IB morphology according to both classifications. Conclusion: This study found a high incidence of Bertolotti Syndrome (over 60%) in patients with low back pain seeking emergency care, suggesting that LSTV should be more frequently considered in differential diagnoses. Improved recognition of LSTV could lead to better management strategies for low back pain associated with this congenital anomaly. Level of Evidence III; Retrospective Cohort Study.