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Bertolotti's syndrome is characterized by sacralization of the lowest lumbar vertebral body and lumbarization of the uppermost sacral segment. It involves a total or partial unilateral or bilateral fusion of the transverse process of the lowest lumbar vertebra to the sacrum, leading to the formation of a transitional 5th lumbar vertebra.
The fifth lumbar spinal nerve 5 (L5) [5] originates from the spinal column from below the lumbar vertebra 5 (L5). L5 supplies many muscles, either directly or through nerves originating from L5. They are not innervated with L5 as single origin, but partly by L5 and partly by other spinal nerves. The muscles are: gluteus maximus muscle mainly S1
Its symptoms include pain, tingling, numbness and muscle weakness. The symptoms affect just one particular part of the body, depending on which nerve is affected. The diagnosis is largely clinical and can be confirmed with diagnostic nerve blocks. Occasionally imaging and electrophysiology studies aid in the diagnosis. Timely diagnosis is ...
Therefore, a combination of signs and symptoms may be more helpful in diagnosing NC than any single feature of the history or physical exam. These signs and symptoms include pain triggered by standing, pain relieved by sitting, symptoms above the knees, and a positive "shopping cart sign". [4] Specific questions that may aid diagnosis include: [10]
The syndrome occurs in 12% of older community-dwelling men [3] and up to 21% of those in retirement communities. [4] Because the leg symptoms in lumbar spinal stenosis (LSS) are similar to those found with vascular claudication, the term pseudoclaudication is often used for symptoms of LSS. [5]
The pain is characteristically described as shooting or shock-like, quickly traveling along the course of the affected nerves. [12] Others use the term as a diagnosis (i.e. an indication of cause and effect) for nerve dysfunction caused by compression of one or more lumbar or sacral nerve roots from a spinal disc herniation. [4]
Pain erupts in response to a stimulus that either damages or can potentially damage the body's tissues. There are four main stages: transduction, transmission, perception, and modulation. [11] The nerve cells that detect pain have cell bodies located in the dorsal root ganglia and fibers that transmit these signals to the spinal cord. [40]
This nerve irritation causes referred pain in a well described tri-branched pattern. The diagnosis is made clinically with the variable presence of four criteria. Descriptions of clinical involvement of posterior rami were found as early as 1893, but not until 1980 that LDRS was so precisely described.