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Abdominal Aortic Aneurysm  

The nurse is assigned to Mr. Sims, a 60 year old man diagnosed with abdominal aortic aneurysm.

The nurse wants to find some information on abdominal aortic aneurysm. She consults Nursing Reference Center, keying in abdominal aortic aneurysm. She consults the quick lesson "Abdominal Aortic Aneurysm."

She reads about abdominal aortic aneurysm, including risk factors, treatment goals, and red flags. The nurse talks to Mr. Sims about abdominal aortic aneurysm, and educates him on the treatment options.

Note: The above referenced Quick Lesson is freely accessible to all readers of the Nursing Reference Center Update. 

Bertolotti syndrome (BS) is a congenital spinal disorder characterized by unilateral or bilateral enlargement of the transverse process of the most caudal lumbar transitional vertebra. Most patients with BS are asymptomatic, but some patients present with chronic, persistent low back pain which is often localized to one side. There may be point tenderness over the area of enlarged transverse process. Certain movements or activities may increase the pain in some people, and the pain is usually relieved with rest. Neurological exam is most often normal and there is rarely any numbness, tingling, or weakness. There may be radiation to the buttock and thigh on the affected side. The etiology is unknown. Bertolotti syndrome is typically a benign finding on a routine X-ray.

There is no clear treatment plan for BS, but the majority of patients achieve pain relief with conservative measures, as opposed to surgery. Treatment usually begins with non-steroidal anti-inflammatory medication (i.e. ibuprofen, naproxen) and physical therapy. If there is not significant relief with these treatments, patients are typically given an injection of local anesthetic, with or without steroid, into the area of the articulation of the enlarged transverse process and the sacrum/ilium. When pain relief is achieved with the injection it can assist in diagnosis, but the pain relief is often only temporary. Radiofrequency neurolysis may provide further pain relief for those who respond to anesthetic block, but this may also only provide temporary pain relief. Minimally invasive surgical resection of the anomalous articulation may be needed if pain is recurrent or unrelenting. If this does not relieve the pain, the patient may require fusion of the posterolateral transitional vertebra. Most patients have relief of their pain with one or more of these treatment options, although patients may not be 100% pain free. Patients and their families need education about BS, treatment options, benefits and risks, and emotional support to assist them in coping with this rare disorder when it is associated with chronic pain.

Please login to your Nursing Reference Center subscription to read the Quick Lesson on "Bertolotti Syndrome."