Bertolotti's syndrome is characterized by anomalous enlargement of the transverse process of the most caudal lumbar segment, causing chronic and persistent
low back pain or
sciatica. We describe the case of a 45-year-old woman who presented with left sciatic
pain and
low back pain due to a recurrent lumbar
disc herniation at L4-5 with Bertolotti's syndrome. Selective L5 nerve root block and local injection of
lidocaine into the articulation between the transverse process and sacral ala temporarily relieved the left sciatic
pain and
low back pain, respectively. To confirm the effect of local injection on
low back pain, we gave a second local injection, which once again relieved the
low back pain. Microendoscopic resection of the pseudoarticulation region and
discectomy successfully relieved all symptoms. This report illustrates the effectiveness of minimally invasive resection of the transverse process for the treatment of
low back pain with Bertolotti's syndrome.