ArticleJournal of orthopaedic case reports2026
Use of Lumbosacral Myofascial Release and Therapeutic Exercises for a Patient with Bertolotti's Syndrome: A Case Report.
Article in Journal of orthopaedic case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Bertolotti's Syndrome is characterized by chronic low back pain due to lumbosacral transitional vertebrae (LSTV), where caudal lumbar vertebrae enlargement leads to fusion or articulation with the sacrum or ilium. This condition results in discogenic disease and mobility restriction, causing pain in the back, hip, groin, and legs, often related to L5 nerve distribution. The discomfort varies and is linked to pathologies from LSTV, including scoliosis and joint issues. LSTV types, categorized by the Castellvi system, range from dysplastic processes to complete sacralization. The syndrome's incidence is debated, estimated at 4-36%. Myofascial release (MFR) is a therapeutic technique targeting fascia to reduce muscle tension, improve mobility, and alleviate chronic pain. Previous studies suggest MFR, combined with other treatments, effectively reduces low back pain. However, research has not specifically assessed MFR's impact on Bertolotti's Syndrome. This study aims to investigate MFR's effects on the thoracolumbar fascia and quadratus lumborum combined with therapeutic exercises for affected patients. Objectives: The objective of the study was to assess the effect of lumbosacral MFR along with therapeutic exercises for a patient with Bertolotti's syndrome. Case Report: The patient underwent 6 weeks of physiotherapy, with sessions 5 times weekly, each lasting 40-45 min. Initial exercises included lumbar flexion in quadruped and standing positions. The Bird Dog exercise involved alternating arm and leg raises. Spinal extension exercises were performed in prone positions. MFR techniques targeted the thoracolumbar fascia and quadratus lumborum, applying sustained pressure for specific durations to alleviate tension. Results: The patient showed significant improvement in symptoms during treatment. The pain score decreased from 6/10 to 1/10, and the Oswestry disability index score was 4/50, indicating no disability. The patient performed daily activities comfortably and sat for 80 min without pain. Conclusion: A patient with LSTV and persistent LBP following prior treatments might have their pain associated with reduced mobility. MFR and therapeutic exercises may serve as effective treatments for cases like type IIB Castellvi LSTV.
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