syndrome name

[bedrock]

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Can one of you remind of syndrome name when a patient has an enlarged L5 tranverse process and they catch the L5 nerve with certain movements?

Just saw a young wrestler with a normal MRI, but on x-ray he has larger than normal L5 transverse processes and slight L5 weakness and classic L5 dermatome radicular pain. Only gets the leg pain with competitive wrestling, not normal exercise or other movements.

 

[cowboydoc]

Bertolotti?

 

[bedrock]

Bertolotti?

No there is another name. Thanks though.

 

[pmrmd]

I’ve never heard of this. I can’t imagine how it would even impinge the root.

 

[Baron Samedi]

Far Out Syndrome

 

[bedrock]

Far Out Syndrome

That is it thanks.

And a great photo to remember it by!

 

[cowboydoc]

Far Out Syndrome

I was waaaay off!

 

[Laryngospasm]

DBTP.. damn big transverse process syndrome?

 

[deleted131481]

Far Out Syndrome

I thought your reply was a joke at first. Never heard of this before.

 

[Ducttape]

a little late but:

Alar transverse process impingement of the L5 spinal nerve: the far-out syndrome - PubMed

This syndrome occurs in two types of patients: (1) the elderly person with degenerative scoliosis and (2) a somewhat younger adult population with isthmic spondylolisthesis and at least 20% slip. On plain radiograph, the Ferguson view (25 degrees caudocephalic) is best for visualizing the...

pubmed.ncbi.nlm.nih.gov

 

[DOctorJay]

Learned something new today. Thanks!

 

[myrandom2003]

can you post any imaging for this?

 

[Orin]

Europe PMC

Europe PMC is an archive of life sciences journal literature.

europepmc.org

Better pictures

https://www.e-neurospine.org/upload/pdf/ns-1938026-013.pdf

 

[MD87]

(Slightly) related question - how do you bill a pseudoarthrosis injection for a patient with Bertolotti's Syndrome? Is it just a trigger point + fluoro?

 

[Orin]

(Slightly) related question - how do you bill a pseudoarthrosis injection for a patient with Bertolotti's Syndrome? Is it just a trigger point + fluoro?

That's the safest. Some bill it as a facet injection but that doesn't seem right.

You could argue for 20600 + 77003