Glossary

Understanding Medical Terms

A Plain English Glossary for Bertolotti Syndrome, LSTV & Chronic Back Pain

Medical words can sometimes feel confusing, especially after reading an X-ray, CT scan, MRI report or specialist letter. This glossary explains common terms in plain English to help you better understand your condition and feel more confident when talking with your healthcare team.

This glossary is designed as a quick reference guide. If you would like to learn more about any topic, explore the related pages throughout our website. Coming Soon to the Members Area - Downloadable PDF with full explanations.

Core Bertolotti Syndrome Terms

• Bertolotti Syndrome

A painful condition caused by a lumbosacral transitional vertebra (LSTV). The extra bone changes the way the lower spine moves, which can lead to pain and other spinal problems.

• Castellvi Classification

The original system used to describe the different types of lumbosacral transitional vertebrae based on their appearance on imaging.

• Jenkins Classification

A newer classification system that not only describes the anatomy but also helps guide treatment decisions for people with Bertolotti Syndrome.

• Lumbarisation

A congenital variation where the first sacral vertebra develops as an extra lumbar vertebra, giving a person six lumbar vertebrae instead of the usual five.

• Lumbosacral Transitional Vertebra (LSTV)

A congenital variation where the lowest lumbar vertebra or highest sacral vertebra develops differently from normal, creating an abnormal connection between the spine and pelvis.

• Pseudo-articulation

A "false joint" formed when an enlarged transverse process partially joins the sacrum or pelvis instead of forming a normal joint.

• Sacralisation

A congenital variation where the lowest lumbar vertebra (usually L5) becomes partly or completely joined to the sacrum.

• Sacralised L5

An L5 vertebra that is partially or completely fused or joined to the sacrum.

• Transitional Vertebra

A vertebra that has features of two different parts of the spine. In Bertolotti Syndrome, this usually occurs where the lumbar spine meets the sacrum.

• Transverse Process

The bony projection on each side of a vertebra. In Bertolotti Syndrome, it may be enlarged and form an abnormal connection with the sacrum or pelvis.

Anatomy Terms

• Facet Joint

Small joints at the back of the spine that guide movement and help keep the spine stable.

• Intervertebral Disc

A soft cushion between each vertebra that acts as a shock absorber and allows the spine to move.

• Ilium

The large wing-shaped bone on each side of the pelvis.

• Lumbar Spine

The lower part of the spine, made up of the five lumbar vertebrae (or six in people with lumbarisation).

• Nerve Root

The beginning of a spinal nerve as it leaves the spinal cord. If compressed, it can cause pain, numbness or weakness.

• Pelvis

The ring of bones that connects the spine to the hips and legs.

• Sacrum

A triangular bone at the base of the spine that connects the lumbar spine to the pelvis.

• Sacroiliac Joint (SIJ)

The joint where the sacrum meets the pelvis. It helps transfer weight between the upper body and the legs.

• Spinal Canal

The tunnel through the centre of the spine that protects the spinal cord and nerves.

• Vertebra

One of the individual bones that make up the spine.

• Coccyx (Tailbone)

The small bone at the very bottom of the spine. Pain in this area is called coccydynia and can occur after a fall, prolonged sitting or changes in the way the pelvis moves.

Symptoms & Conditions

• Anterolisthesis

A condition where one vertebra slips forward over the vertebra below it.

• Chronic Pain

Pain that lasts for more than three months and may continue even after an injury has healed.

• Coccydynia

Pain in the tailbone (coccyx). It may be caused by injury, prolonged sitting, childbirth or changes in posture and pelvic alignment.

• Degenerative Disc Disease (Discopathy)

Wear and tear of the spinal discs that can occur with age or because of altered spinal mechanics.

• Facet Joint Arthropathy

Arthritis or wear and tear affecting the facet joints of the spine.

• Far-Out Syndrome

Compression of the L5 nerve outside the spinal canal, often caused by an enlarged transverse process.

• Fibromyalgia

A long-term condition that causes widespread pain, fatigue and increased sensitivity throughout the body. Often diagnosed in place of Bertolotti Sydnrome

• Hemipelvic Elevation

When one side of the pelvis sits higher than the other, affecting posture and body alignment.

• Herniated Disc

A spinal disc that has bulged or ruptured, sometimes pressing on nearby nerves.

• Muscle Spasm

A sudden tightening of a muscle that may occur as the body tries to protect an injured area.

• Muscle Strain

An overstretching or tearing of muscle fibres.

• Nerve Root Compression

Pressure on a spinal nerve that may cause pain, tingling, numbness or weakness.

• Osteophytes

Small bone spurs that develop as a result of arthritis or long-term stress on a joint.

• Pain Generator

The specific structure in the body that is actually causing pain.

• Pelvic Tilt

A change in the normal position of the pelvis that may affect posture and spinal alignment.

• Pseudo-arthrosis

A painful false joint that forms where abnormal movement occurs between bones.

• Radiculopathy

Pain, numbness, tingling or weakness caused by irritation or compression of a spinal nerve.

• Retrolisthesis

A condition where one vertebra slips backwards over the vertebra below it. This is the opposite of anterolisthesis and may contribute to back pain or nerve irritation.

• Sacroiliitis

Inflammation of one or both sacroiliac joints.

• Sciatica

Pain that travels from the lower back into the buttock and down the leg because of irritation of the sciatic nerve.

• Scoliosis

A sideways curve of the spine that may develop because of uneven forces acting on the body.

• SIJ Dysfunction

Pain caused by abnormal movement or irritation of the sacroiliac joint.

• Spondylolisthesis

A condition where one vertebra slips forward over another.

• Spondylosis

General wear and tear or age-related changes affecting the spine.

Congenital Conditions & Comorbidities

• Congenital Cervical Stenosis

A condition present from birth where the spinal canal in the neck is naturally narrower than normal. This may increase the risk of pressure on the spinal cord or nerves.

• Congenital Extra Ribs (Cervical Ribs)

An extra rib that develops above the first rib. Some people never know they have one, while others may develop nerve or blood vessel compression.

• Cranio-Cervical Instability (CCI)

Excessive movement where the skull meets the upper neck. It is sometimes associated with connective tissue disorders such as Ehlers-Danlos Syndrome.

• Ehlers-Danlos Syndrome (EDS)

A group of inherited connective tissue disorders that can affect joints, ligaments, skin and other tissues. Some people with EDS have very flexible joints and may experience chronic pain.

• Hypermobility

Joints that move beyond the normal range of motion. Some people are naturally flexible, while others may develop pain or instability.

• Hypermobility Spectrum Disorder (HSD)

A condition where joint hypermobility causes pain or other symptoms but does not meet the full criteria for Ehlers-Danlos Syndrome.

• L6 Vertebra

An extra lumbar vertebra present from birth. Instead of five lumbar vertebrae, some people naturally have six.

• Lumbarisation

A congenital variation where the first sacral vertebra develops as an extra lumbar vertebra, creating an L6 vertebra.

• Spina Bifida Occulta

A common congenital variation where the bones at the back of the spine do not fully close. Many people never know they have it because it often causes no symptoms.

• Thoracic Outlet Syndrome (TOS)

A condition where nerves or blood vessels become compressed between the neck and shoulder, causing pain, numbness or weakness in the arm or hand.

• Transitional T12

A variation where the twelfth thoracic vertebra has features of both the thoracic and lumbar spine.

Assessment & Examination Tests

• Diagnostic Injection

An injection of local anaesthetic, sometimes combined with cortisone, into a suspected pain source. If the pain improves significantly, it helps identify where the pain is coming from.

• FABER Test

A physical examination used to assess the hip and sacroiliac joint. It may reproduce pain but cannot diagnose Bertolotti Syndrome on its own.

• Fortin Finger Test

A simple test where a patient points with one finger to the area of pain over the sacroiliac joint. It may suggest the SIJ is contributing to symptoms.

• Gaenslen's Test

A physical examination used to place stress on the sacroiliac joint to see if it reproduces pain.

• Oswestry Disability Index (ODI)

A questionnaire that measures how much back pain affects daily activities such as walking, sitting, lifting and sleeping.

• Schober's Test

A physical examination used to measure how well the lower back bends forward.

• Straight Leg Raise (SLR)

A test used to assess whether a spinal nerve may be irritated or compressed, often in people with sciatica.

• Thigh Thrust Test

A physical examination used to help identify pain coming from the sacroiliac joint.

• Visual Analogue Scale (VAS)

A simple pain rating scale where people rate their pain from 0 (no pain) to 10 (worst pain imaginable).

Imaging & Diagnostic Tests

• AP (Anterior-Posterior) X-ray

An X-ray taken from the front of the body to the back. It helps show the alignment of the spine and pelvis.

• Bone Scan

A nuclear medicine scan that looks for areas of increased bone activity, which may indicate inflammation or abnormal stress.

• CT (Computed Tomography) Scan

A detailed scan that uses X-rays to create cross-sectional images of the bones and joints.

• Ferguson X-ray

A specialised X-ray angled towards the lumbosacral junction to provide a clearer view of a lumbosacral transitional vertebra.

• Lateral X-ray

An X-ray taken from the side of the body to show the alignment of the spine.

• MRI (Magnetic Resonance Imaging)

A scan that uses magnets to produce detailed images of discs, nerves, muscles and other soft tissues.

• Standing Full-Length X-ray

An X-ray taken while standing that shows the entire spine and pelvis. It helps assess posture, spinal balance and alignment.

• SPECT-CT Scan

A specialised scan that combines a bone scan with a CT scan to identify areas of increased bone activity that may be causing pain.

• Ultrasound

A scan that uses sound waves to create images. It is commonly used to help guide injections into joints or soft tissues.

• X-ray

A simple imaging test that uses low-dose radiation to examine bones and identify structural abnormalities.

Understanding Your Imaging Report

These are common words and phrases you may see in your X-ray, CT or MRI report.

• Alignment Preserved

The bones of the spine are sitting in their normal position.

• Asymmetrical

One side is different from the other. This may refer to the bones, joints or muscles.

• Bilateral

A finding that affects both the left and right sides.

• Bone Marrow Oedema

An area of increased fluid within the bone that may indicate inflammation, stress or injury.

• Canal Narrowing

A reduction in the space available for the spinal cord or nerves. Also known as spinal stenosis.

• Congenital Variant

A difference in the way part of the body developed before birth. It is not something that has been caused by injury.

• Degenerative Changes

General wear and tear of the spine that may occur with age or increased stress on the joints and discs.

• Disc Bulge

A spinal disc that extends beyond its normal boundary. A disc bulge does not always cause pain.

• Disc Height Loss

A reduction in the thickness of a spinal disc, often due to wear and tear or degeneration.

• Endplate Changes

Changes to the bone above or below a spinal disc, often associated with disc degeneration.

• Facet Hypertrophy

Enlargement or thickening of the facet joints, usually caused by arthritis or long-term wear.

• Foraminal Narrowing

Narrowing of the opening where a spinal nerve leaves the spine. This may place pressure on the nerve.

• Foraminal Stenosis

Another term for narrowing of the nerve openings in the spine.

• Hypertrophy

An increase in the size or thickness of a bone, joint or ligament.

• Incidental Finding

A finding discovered during a scan that is unrelated to the reason the scan was performed.

• Ligamentum Flavum Hypertrophy

Thickening of one of the spinal ligaments that may contribute to spinal canal narrowing.

• Mild

A small or early change seen on imaging. It does not always reflect how much pain someone experiences.

• Moderate

A change that is more noticeable than mild but not considered severe.

• Neural Foramen

The small opening where each spinal nerve exits the spine.

• No Acute Abnormality

No recent injury, fracture or serious new problem has been identified.

• No Significant Stenosis

No major narrowing of the spinal canal or nerve openings has been found.

• Osteophytes

Small bone spurs that develop because of arthritis or long-term stress on the spine.

• Posterior Disc Bulge

A disc bulge that extends towards the back of the spine.

• Rudimentary Disc

A small or underdeveloped disc, often seen with transitional vertebrae.

• Sclerosis

An area of bone that has become denser or harder, usually due to increased stress or arthritis.

• Spondylotic Changes

Age-related or degenerative changes affecting the spine.

• Transitional Anatomy

An anatomical variation where a vertebra has features of two different parts of the spine.

• Unilateral

A finding that affects only one side of the body.

• Vacuum Disc Phenomenon

Small pockets of gas within a spinal disc that usually indicate advanced disc degeneration.

Treatment Terms

• Activity Modification

Changing the way everyday activities are performed to reduce pain and avoid placing extra stress on the spine.

• Bone Wax

A special wax sometimes used during surgery after removing an enlarged transverse process. It may help reduce the chance of bone growing back.

• Conservative Treatment

Treatment that does not involve surgery, such as medication, exercise, physiotherapy or injections.

• Cortisone Injection

An anti-inflammatory injection used to help reduce pain and swelling around joints or nerves.

• Diagnostic Injection

An injection used to confirm whether a specific joint or structure is the source of pain.

• Endoscopic Spine Surgery

A minimally invasive surgical technique performed through a very small incision using a tiny camera and specialised instruments.

• Exercise Therapy

A personalised exercise program designed to improve strength, flexibility and movement while helping to reduce pain.

• Fusion Surgery

An operation that permanently joins two or more bones together to stop painful movement.

• Minimally Invasive Surgery (MIS)

Surgery performed through small incisions using specialised instruments, often resulting in less tissue damage and a quicker recovery.

• Pain Management

A combination of treatments used to help reduce pain and improve quality of life.

• Physiotherapy

Treatment that uses movement, exercise, education and hands-on techniques to improve strength, mobility and function.

• Radiofrequency Ablation (RFA)

A procedure that uses heat to interrupt pain signals from specific nerves, providing pain relief for some people.

• Rehabilitation

A structured recovery program designed to help restore movement, strength and everyday function after injury or surgery.

• Resection Surgery

An operation that removes the enlarged transverse process or pseudo-joint causing pain in some people with Bertolotti Syndrome.

• Spinal Decompression

Surgery performed to relieve pressure on the spinal cord or nerves.

• Spinal Fusion

Another term for fusion surgery, where vertebrae are permanently joined together.

• Steroid Injection

An injection used to reduce inflammation and relieve pain around joints, nerves or soft tissues.

• TLIF (Transforaminal Lumbar Interbody Fusion)

A type of spinal fusion performed through the side of the spine to remove a damaged disc and stabilise the affected level.

• PLIF (Posterior Lumbar Interbody Fusion)

A spinal fusion performed through the back of the spine.

• ALIF (Anterior Lumbar Interbody Fusion)

A spinal fusion performed through the front of the abdomen.

• XLIF (Extreme Lateral Interbody Fusion)

A spinal fusion performed through the side of the body using a minimally invasive approach.

• OLIF (Oblique Lumbar Interbody Fusion)

A minimally invasive fusion performed through an angled approach at the side of the abdomen.

• Artificial Disc Replacement (ADR)

A procedure where a damaged spinal disc is replaced with an artificial disc to help preserve movement in carefully selected patients.

• TOPS™ System

A motion-preserving spinal implant designed to replace the function of the facet joints after decompression surgery in selected patients. It is a newer technology that may help maintain movement instead of permanently fusing the spinal segment. Research is ongoing, and its role in treating Bertolotti Syndrome has not yet been established.