Onyiuke Grading Scale: A clinical classification system for the diagnosis and management of Bertolotti syndrome

Knopf, Joshua; Lee, Subin; Bulsara, Ketan R.; Moss, Isaac L.; Choi, David; Onyiuke, Hilary

doi:10.1016/j.neuchi.2021.05.002

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…Using sagittal MRI, O’Driscoll et al 28 classified Bertolotti’s syndrome into four types based on the morphology of the S1–S2 disc and the extent of lumbarization of the S1 segment, with a correlation between O’Driscoll type 4 and Castellvi type III or type IV. The Onyiuke Grading Scale, a novel grading system, classifies Bertolotti’s syndrome into four types according to the location, severity, and characteristics of the pain, with an extensive focus on clinical symptoms and less consideration of imaging outcomes 41 .…”

Section: Discussionmentioning

confidence: 99%

Characteristics, treatment and research development of bertolotti’s syndrome: a bibliometric analysis and systematic review

Zhu

Ding

Zheng

et al. 2023

International Journal of Surgery

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Purpose: Bertolotti’s syndrome is a prevalent congenital deformity. However, many physicians fail to include it in their differential diagnosis for low back pain (LBP), which results in missed diagnosis or misdiagnosis. There is still a lack of standardized treatment and management strategies for Bertolotti’s syndrome. This study aimed to review the clinical characteristics and management of Bertolotti’s syndrome and reports bibliometric insights in advancements in Bertolotti’s syndrome research. Methods: Studies published until 30 September 2022 were systematically reviewed according to the PRISMA guidelines. Three independent reviewers extracted the data and assessed the quality and risk of bias of the studies based on the methodological index of non-randomized studies (MINORS). SPSS, VOS viewer, and the Citespace software were used for the systematic review, visual analysis, data mining, mapping, and clustering of the retrieved articles, which presented clear and visual presentations of the structural patterns of published research in graphs. Result: A total of 118 articles, describing a total of 419 patients with Bertolotti’s syndrome, were included. There was an upward trend with a steady increase in the number of publications. The world map distribution showed that most publications were predominantly from North America and Asia. The most cited articles were published in the following journals: Spine, J Bone Joint Surg, and Radiology. The mean age of the patients was 47.7 years, and 49.6% of them were male. A total of 159 (96.4%) patients had LBP symptoms. The mean symptom duration was 41.4 months (74.8%), and most of the patients had Castellvi type II. Disc degeneration was the most reported comorbid spinal diseases. The mean methodological index of non-randomized studies score was 4.16±3.95 points (range, 1–21). A total of 265 (68.3%) patients underwent surgical treatments. Minimally invasive surgical techniques, prevalence, image classification, and disc degeneration were the current main research areas of Bertolotti’s syndrome. Conclusions: The steady increase in the number of publications demonstrated the increased attention of researchers on this topic. Our results showed a significant prevalence of Bertolotti’s syndrome in patients with LBP and a long symptom duration before the initiation of treatment. Surgical treatments were commonly used to treat patients with Bertolotti’s syndrome after a non-effective conservative treatment. Minimally invasive surgical techniques, prevalence, image classification, and disc degeneration are the major research areas of Bertolotti’s syndrome.

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Section: Discussionmentioning

confidence: 99%

Characteristics, treatment and research development of bertolotti’s syndrome: a bibliometric analysis and systematic review

Zhu

Ding

Zheng

et al. 2023

International Journal of Surgery

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“…Moreover, Elster et al [10] found that herniated discs are most common just above the LSTV segment. Knopf et al [11] proposed the Onyiuke grading and treatment algorithm to enhance the clinical utility of Castellvi types. Jenkins et al [12] introduced the Jenkins classification, noting that Castellvi types do not encompass all anatomical variations.…”

Section: Discussionmentioning

confidence: 99%

Pulsed Radiofrequency Treatment in Patient with Lumbar Radiculopathy Due to Bertolotti's Syndrome: A Case Report

Bae,

Gang,

Kim

et al. 2023

IJP

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Bertolotti's syndrome (BS) is a condition that causes lower back pain due to the presence of a lumbosacral transitional vertebra (LSTV). A spectrum of therapeutic modalities, ranging from conservative management to surgical intervention, has been endeavored in its management. It has been reported that LSTV may subsequently lead to conditions such as scoliosis, facet joint arthritis, strains of the quadratus lumborum and iliopsoas muscles, and herniated discs. Moreover, BS commonly manifests with lower back pain; however, it is rarely associated with radiation-induced leg pain. In this case report, we aimed to investigate the effectiveness of pulsed radiofrequency treatment in patients who underwent diagnostic nerve blocks for radicular pain suspected to be induced by BS and demonstrated temporary pain relief.

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“…The Onyiuke Grading Scale, a new grading system, classifies BS into 4 types based on the location, severity, and characteristics of the pain, focusing on clinical symptoms and less on imaging results [26]. Regarding the Jenkins classification, this new description of LSTV anatomy bases itself on the concept of a reduced gap between the TP and the sacrum as the primary cause of BS rather than disc herniation [27].…”

Section: Classification Of Lstvmentioning

confidence: 99%

Surgical Options for Bertolotti Syndrome

Ahn,

Seo,

et al. 2024

J Minim Invasive Spine Surg Tech

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This article provides a comprehensive examination of Bertolotti syndrome (BS), a disorder characterized by back pain due to a lumbosacral transitional vertebra, to facilitate surgical decision-making by exploring various surgical options, including the innovative approach of endoscopic spine surgery. A review of existing literature and studies on BS published until December 2023 was undertaken, utilizing databases such as PubMed and Google Scholar to identify relevant information. The review offers an integrated overview of the essential knowledge of BS and a comprehensive range of surgical treatments. Symptomatic BS can manifest as pain originating from pseudoarticulation and the facet joints, discs, adjacent segments, and the L5 root, indicating a diverse distribution of pain sources. Furthermore, various surgical strategies are tailored to the specific origin of pain, including pseudoarticulation resection, transverse processectomy, decompression, nerve root decompression, fusion, and endoscopic spine surgery. For individuals with BS contemplating surgical solutions, performing a detailed assessment of symptoms and physical evaluations is imperative to accurately identify the origin of the pain. The choice of a surgical strategy must be meticulously customized according to the identified source of pain, guaranteeing a tailored and efficacious treatment for each patient.

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Onyiuke Grading Scale: A clinical classification system for the diagnosis and management of Bertolotti syndrome

Cited by 7 publications

References 21 publications

Characteristics, treatment and research development of bertolotti’s syndrome: a bibliometric analysis and systematic review

Characteristics, treatment and research development of bertolotti’s syndrome: a bibliometric analysis and systematic review

Pulsed Radiofrequency Treatment in Patient with Lumbar Radiculopathy Due to Bertolotti's Syndrome: A Case Report

Surgical Options for Bertolotti Syndrome

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