Very rare. Presence of a 'mega' lumbar transverse process at the level of the last lumbar vertebra, articulated via a neo-articulation with the upper part of the sacrum or ileum. It is a source of back pain.

This anomaly can be associated with spina bifida occulta.

Treatments:

-         NSAIDS

-         intra-neoarticular injection of steroids (under CT or ultrasound guidance)

-         radioablation of the neoarticulation

-         surgical excision of all or part of the transverse process

Anesthetic implications: 

check for spina bifida occulta before performing a neuraxial block.

References :  

-        Mercader Rodriguez B, Fernandez-Sanchez R, Domenech Abellan J et al. 
Bertolloti syndrome : a little known cause of low-back pain in childhood. 
J Pediatr 2015: 166:202-3.

Updated: November 2019