Bertolotti's Syndrome: Injection Vs. Conservative Management – A Comparative Study

Objective: Bertolotti's syndrome, characterized by the presence of lumbosacral transitional vertebrae (LSTV), is a common cause of low back pain. This study compares the effectiveness of injection therapy versus conservative management in relieving pain and reducing recurrence in patients with Bertolotti's syndrome. Materials and Methods: A retrospective study was conducted at the Department of Neurosurgery, Lady Reading Hospital-MTI, Peshawar from January 2021 to December 2023. Fifty patients diagnosed with Bertolotti's syndrome were divided into two groups: 25 received injection therapy, and 25 underwent conservative management. Data on pain relief, recurrence rates, patient satisfaction, and complications were analyzed. With significance set at p < 0.05, the two groups were compared statistically using chi-square and t-tests. Results: Injection therapy resulted in significantly greater pain relief (84%) compared to conservative management (60%) (p = 0.03). Regarding recurrence rates, they were lower in the injection group (24%) compared to the conservative group (40%) (p = 0.04). Patient satisfaction was equivocal between the two groups (p = 0.35). The incidence of minor complications was higher with Injection therapy including localized tenderness and temporary nerve irritation. Conclusion: Injection therapy is better in short-term pain relief and lower recurrence rates in patients having Bertolotti's syndrome. However, long-term outcomes are similar between injection therapy and conservative management approaches.