Document Type

Article

Publication Date

2026

DOI

10.7759/cureus.109205

Publication Title

Cureus

Volume

18

Issue

5

Pages

e109205

Abstract

Bertolotti's syndrome is a congenital condition characterized by chronic low back pain stemming from a lumbosacral transitional vertebra (LSTV). Because the condition is frequently overlooked, patients often face years of delayed diagnosis before the true source of their pain is identified. Furthermore, current information regarding the biological origins and clinical management of the condition remain scattered. To address this knowledge gap, this narrative review aims to provide a comprehensive overview of Bertolotti’s syndrome by consolidating these disparate sources and suggesting new connections. We synthesize the latest understanding of this condition, ranging from its genetic origins to modern clinical management. We examine the biomechanical alterations caused by an LSTV and discuss the advantages of Jenkins classification over Castellvi classification. The diagnostic protocol is presented as a multi-step process, emphasizing the necessity of fluoroscopy-guided diagnostic injections to distinguish incidental findings from true pathology. Finally, we present the consensus treatment protocol based on the latest findings and identify critical gaps in the literature regarding standardized care protocols, unified clinical nomenclature, and long-term surgical outcomes.

Rights

© 2026 The Authors.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Original Publication Citation

Tsegaye, M., & Muffly, A. (2026). A narrative review of Bertolotti's syndrome: Etiology, classification, diagnosis, and treatment. Cureus, 18(5), Article e109205. https://doi.org/10.7759/cureus.109205

Download

Share

COinS