• Hatem Afana, Muhammad Raffat, and Nicandro Figueiredo.
• Orthopaedic Surgeon, Department of Orthopaedic & Spinal Surgery, King's College Hospital London, Dubai, UAE.
• Medicine (Baltimore). 2022 Dec 16; 101 (50): e32293e32293.

RationaleBertolotti's syndrome is one of the differential causes of low back pain, especially within young people. The etiopathogenesis of the typical paramedian low back pain, associated with Bertolotti's syndrome remains controversial, and there is no worldwide acceptance of treatment.Patient ConcernsThis article presents the authors experience with surgical treatment of symptomatic patients with Bertolotti's syndrome.DiagnosesRetrospective study of a selected series of patients with symptomatic Bertolotti's syndrome submitted to surgical treatment.InterventionsThis study included 16 patients, being 8 submitted to the new modified mini-open tubular microsurgical transverse processectomy, Among those patients, intraoperative fluoroscopy was used in 6 surgeries to locate the base of the enlarged transverse process (6/8); intraoperative neuromonitoring was used in 6 patients (6/8), 3D intraoperative advanced spinal image (O-arm) with neuronavigation was used to localize the base of the pseudojoint to be removed and to check the final bone resection for the last 5 cases (5/8).OutcomesThe average paramedian lower back pain before surgery on the visual analogue scale for pain in the 8 patients was 6.6 (range: 5-8) and reduced to 1.5 (range: 0-3) at the latest follow-up after surgery, while the average pain score of the radicular pain on the right or left side before the surgery was 1.3 (range: 0-6) and reduced to 0.6 (range: 0-7) after the surgery.LessonsThe mini-open tubular microsurgical transverse processectomy seems to be potentially safe and effective for the surgical treatment of selected symptomatic patients with Bertolotti's syndrome.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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