Bertolotti Syndrome is a known cause of back pain that comes from an unusual link between the lowest lumbar vertebra, called L5 and the sacrum. This special connection is there from birth. For most people, symptoms do not become apparent unless there is irritation of tissues surrounding the location. It may take some time before the condition becomes apparent and for people to develop symptoms, often when pain becomes more localized and specific. Bertolotti Syndrome may manifest later on in one's life.
The condition involves a transitional vertebra. This is a difference where the lower back meets the sacrum. In some people a larger side part of the L5 bone touches. Connects with the sacrum or the pelvis. This can create a joint or a partial joining, at the bottom of the spine. This can add pressure to the nearby discs and joints.
The signs of Bertolotti Syndrome are:
Some people have the variation, without any symptoms at all. So imaging alone does not confirm the syndrome.
An expert in spinal pain will need to correlate pain location and type of pain to the anomalous facet joint. Through examination and testing, physicians can confirm whether or not the presence of a transitional vertebra is the source of the patient's symptoms. Back pain, if left unmanaged, may interfere with the patient’s quality of life.
The variation develops before birth. Pain may be associated with:
New leg weakness or numbness of the perineum/groin, as well as a loss of bladder or bowel control, are signs for immediate emergency evaluation. Variation is not problematic unless it causes symptoms.
First, your symptoms are reviewed, followed by tests to see the movement of your joints, the amount of strength in your legs, reflexes and your ability to sense pain and temperature. X-rays show where the vertebra of transition is. CT scans provide a view of the bony connections. Magnetic Resonance Imaging scans show if you have a disc issue or any nerve pain that can explain your pain. To treat you with an injection or surgery, the right level in the spine must be identified. Sometimes a joint can be painfully blocked. An anaesthetic is injected into the suspected joint.
Usually, back pain is first treated non-surgically. Options include:
Treatments depend on the symptoms. Having an observable transitional vertebra doesn’t always mandate treatment or surgery.
Patients Success Stories
I would like to express my sincere gratitude to Dr Irfan Malik and his outstanding team for the exceptional care I received before, during and after my revision discectomy surgery.
After everything I had been through, I was understandably anxious about undergoing another surgery, but from the very beginning I felt that I was in safe and capable hands. Dr Malik took the time to explain everything clearly, listened to my concerns and gave me confidence throughout the whole process.
I am incredibly happy to say that the surgery went very well. My recovery has been so much better than I could have hoped for, and most importantly, I am now pain-free and able to enjoy everyday life again.
I cannot thank Dr Malik and his entire team enough for their professionalism, expertise, kindness and support. I will always be extremely grateful for what they have done for me.
Thank you, Dr Malik, and the whole team, for giving me my quality of life back. I would wholeheartedly recommend them to anyone who is considering treatment.
Great personal care! Ensuring I had the best possible outcome.
I would like to sincerely thank Mr Irfan Malik and his wonderful team for the outstanding care and treatment I received at The Harley Street Clinic in March.
From my initial consultation through to my surgery and recovery, every member of staff was professional, attentive, and incredibly supportive. My microdiscectomy at L5 was performed at 35 Weymouth Street, and the entire experience exceeded my expectations. The nurses and medical team could not have done more to make me feel comfortable and reassured me throughout.
I feel extremely fortunate to have had Mr Malik as my consultant. Six weeks after surgery, I am now pain free for the first time in six months. I have started physiotherapy and am already becoming stronger and more mobile each week.
The care I received was truly second to none, and I would not hesitate to recommend Mr Malik and his team to anyone considering spinal surgery.
Mr Malik was wonderful, he has paid attention to my symptoms and explored through tests how he could best help me with a plan for every outcome. He identified the damaged nerves that had plagued the last 40 years of my life and used pioneering surgery to obliterate the nerve endings. Recovery began immediately…. And although I have a long way to go I know so am in safe hands
Before surgery, I was in severe pain caused by a large L4/L5 disc herniation. I cannot recommend Irfan Malik highly enough.
From the initial consultation, I felt reassured that I was in expert hands. He clearly explained all treatment options and the likely outcomes, and in my case, surgery was the most appropriate path forward.
Although the operation was already scheduled, I experienced a sudden and severe flare-up 3 days beforehand. I felt a “pop” in my back that left me barely able to stand or walk beyond the bathroom. I was admitted to hospital earlier than planned, and Mr Malik was willing to come in and operate late on a Friday evening if needed. This meant a great deal to me.
Mr Malik performed an endoscopic discectomy and found that the nerve was severely compressed and inflamed. The result was immediate. I woke up with complete relief from the leg pain, and within days I was walking comfortably again. The only way I can describe it is like having a splinter removed. Waking up pain-free felt surreal, but it was real.
My recovery has exceeded all expectations. Four weeks on, I feel completely back to normal and have started physiotherapy. Throughout the entire process, Mr Malik was calm, clear, and highly professional, which made a very difficult situation much easier for both me and my partner.
I would also add that Fortius Clinic, where the procedure took place, was outstanding. The level of care and comfort was exceptional, more like a five-star hotel than a medical facility.
I, along with many others, owe Mr Malik a debt of gratitude that is hard to put into words.
Mr Irfan gave me confidence in his ability to successfully resolve my issue and delivered as promised (cervical spine disc replacement).
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I had Rt foot drop with lack of function and sensory impairment for several months before surgery.
I have got sensation back in my Rt lower limb and no doubt will regain function as well. This was unimaginable just a few months ago- it’s truly astonishing to have noticed such a difference…testament to excellent surgery done by Mr Malik and his team!
Mr I Malik was thorough, patient and explained things and nothing was too much trouble. He checked in at regular intervals to make sure things were progressing well and I can only say I can barely contain my delight!! Mr I Malik is a true gentleman with exemplary bedside manners and goes without saying being highly skilled at what he does!!
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Excellent spinal surgeon who has given me back painfree mobility - would recommend to anyone needing lumbar decompression!
My experience of having Mr Malik as a surgeon was excellent. He explained the underlying problem in simple terms, explained my treatment options and escalated the speed of arranging surgery in response to my high pain level. The surgery went as planned and the follow up appointments were very helpful. Mr Malik also has a very professional and personable approach which is reassuring at a time of being unwell and nervous
I underwent a TLIF procedure abroad which unfortunately left me with significant disability and ongoing pain. My spine was tilted to the left, and the implant had not been properly secured, resulting in forward migration and serious complications.
I was subsequently referred to Mr Irfan Malik, who performed an ALIF surgery in January last year. From the outset, his approach was thorough, reassuring, and highly professional. He remained closely involved throughout my recovery, providing consistent follow-up and clear guidance at every stage.
I had repeat imaging two weeks ago, which has confirmed an excellent outcome. I have now been cleared to return to the gym and resume normal activities, something I did not think would be possible at one stage.
I am extremely grateful for the care, expertise, and commitment shown.
Highly recommended.
Dr Malik was superb in seeing me on such short notice and the operation went smooth as can be. Highly recommend!
Great service
Excellent Surgeon and Care
I recently had surgery performed by Mr
Irfan Malik, and I couldn’t be more grateful for the care I received. From the very first consultation, the doctor was professional, reassuring, and took the time to explain everything clearly. The surgery went smoothly, and I felt confident and well looked after throughout the entire process.
The recovery has gone really well, and I’m already feeling much better. I also want to thank the medical team and nurses for their kindness and care — they made a stressful time much easier to handle.
I highly recommend Mr Malik to anyone in need of surgery.
Exceptional care — truly life-changing
I recently underwent spinal decompression surgery with Dr. Irfan Malik (Neurosurgeon), and I am deeply grateful for the outstanding care I received. From our very first consultation through the operation and immediate recovery, Dr. Malik was professional, reassuring, and thoroughly attentive.
He explained the procedure step by step in clear, easy-to-understand terms and patiently answered all of my questions — which made me feel confident and well-informed before going into surgery. The operation was successful: I experienced relief from my nerve pain straight after the surgery. Aside from normal post-surgical discomfort, which resolved within about a week, my symptoms improved dramatically and my recovery has been smooth.
Dr. Malik’s bedside manner is warm and empathetic. He communicated in a friendly and respectful way, and I always felt heard and cared for. His skill and attention to detail were evident throughout the whole process.
I wholeheartedly recommend Dr. Irfan Malik to anyone seeking a knowledgeable and compassionate neurosurgeon. His combination of technical excellence and genuine empathy made a real difference in my recovery
- CATHIRAVAN ILANGOVAN
I am 29 years old and was in debilitating pain for 5 years before the surgery, I tried everything, and now I am completely pain free.
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I recently had a microdiscectomy at L5/S1 with Mr Malik and couldn’t be happier with the outcome. His professionalism, warmth, and expertise put me completely at ease throughout the process. I felt fully supported throughout and had absolute trust in him and his team. I’m very grateful for the care I received and would recommend Mr Malik without hesitation.
I would like to express my deepest gratitude to Dr. Irfan Malik, Neurosurgeon, for the exceptional care and expertise he provided during my spinal surgery. Before the procedure, I was suffering from very severe back, hip, and leg pain (over a decade)that made daily life extremely difficult. I was in constant discomfort and struggling just to get through the day.
From the initial consultation to the post-operative care, Dr. Malik demonstrated not only outstanding professionalism but also genuine compassion and reassurance every step of the way. He took the time to explain everything clearly, answer all my questions, and help me feel confident moving forward with the surgery.
I’m now on the path to recovery, finally free from the pain that had taken over my life. Dr. Malik’s calm demeanor, clear communication, and thorough approach gave me confidence and peace of mind throughout the process.
I truly feel fortunate to have had Dr. Malik as my Neurosurgeon. His work has made a profound difference in my life, and I wholeheartedly recommend him to anyone in need of spinal care.
Thank you again, Dr. Malik, for giving me a new lease on life. I am forever grateful for your exceptional skill and compassion.
Had a really positive experience. I had a fractured L5. Received treatment from Mr Malik. Pain has totally subsided. Would totally recommend Mr Malik
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