Bertolotti's, Pseudoarticulation, transitional vertebra

[Lefty67]

Not a question, but an informational post.

For almost 5 years I have been dealing with low back and right hip pain. I have had x-rays and two MRI's. Both show a transitional vertebra with a pseudoarticulation  on the right side at L5. I have some degenerative changes at L3/L4 and L4/L5 and L5/S1. No nerve impingement or any other affects from the degenerative changes. No bulging discs. The right hip area is the initial source of things.

After almost 5 years, I finally have a solution in sight! My spine specialist did an injection at the point of the pseudoarticulation just over a month ago. It was a major success! We are doing a second one next week, and if that one has the same results then we will be talking with a surgeon about removing the excess bone (pseudoarticulation). Before we did the injection doc didn't think the surgery would do much. The success of the first injection apparently shows that I will be a good candidate for the surgery after all.

If you have a transitional vertebra with a pseudoarticulation, keep pushing the docs to take this seriously! I could see the anomoly on my x-rays, but all the docs tried pushing it off as normal. It's not! A transitional vertebra may be normal in and of itself, but with the pseudoarticulation, you have a recipe for back pain.

[Kristen_rich1112]

I have a bulging disc along with other problems and I fell. My most recent xray says s1 appears transitional compatible with developmental variation. There is a small s1 s2 disc. There is suggestion of bilateral s1 s2 sacral Ala variation. What does this mean? I have severe pain and I'm young so nobody listens to me.

[ccamp]

Hi Lefty,

Myself and my identical twin sister both have the same problems as you. We have suffered from lower back pain since we can remember however when I feel pregnant with my first child is when the severe pain started . I had to be signed out of work 12 weeks into my pregnancy. I had all the same symptoms as yourself could sit, stand or ly down for short periods of time without being in a lot of pain.
After the pregnancy I had an xray and they found the anomaly in my lower back a transverse process (a bony protrusion near the vertebra) is partially attached to the sacrum, or “sacralized”. If this bony protrusion is attached to the sacrum, it can create a rudimentary joint (pseudoarticulation) where there shouldn’t be one.

I had a CT guided injection of steroids which really helped, the doctors tried to tell me that the anomaly should NOT cause pain however I can not explain the amount of pain I was in with my pregnancy and after.

When did your pain start and have you any children?

[Lefty67]

Forgot to add that the things that increase my pain are sitting for long periods, driving, squatting, bending, and sitting cross-legged (both feet tucked under type). Symptoms include numbness/tingling in the right hip and down the right leg, pain in the right hip near the top of the hip bone, unsteady feeling in the hip area, and when I don't slow down and make myself take it easy, the pain moves into my lower back as a tight feeling.

Sometimes something as simple as a stretch will put me down for days.

I have gone through physical therapy, medications (pain killers, muscle relaxers, etc), and even had one doc tell my I need to change my diet. While I'm not a fan of 'rabbit food' I do eat veggies, chicken, fish, beef, fruits, etc. My diet is actually fairly good and wasn't much different that the suggested foods etc. The only thing I do that I will stop doing is smoking. I have had it suggested by every doctor, but now that I have a doc that takes things seriously and is actually helping me, I will quit.

Suggested diagnoses over the last several years from various docs include piriformis syndrome, sciatica, IT Band problem, SI Joint dysfunction (ruled out by x-rays), and lumbago.