▁ ▁It ▁is ▁named ▁for ▁Mario ▁Bert ol otti , ▁an ▁Italian ▁phys ician ▁who ▁first ▁described ▁it ▁in ▁ 1 9 1 7 . ▁ ▁Pres entation ▁A ▁chron ic , ▁persistent ▁low ▁back ▁pain ▁along ▁with ▁but to ck ▁pain ▁is ▁the ▁most ▁important ▁presentation . ▁Rad icular ▁pain ▁is ▁observed . ▁ ▁Path oph ys i ology ▁Bert ol otti ' s ▁synd rome ▁is ▁character ized ▁by ▁sac ral ization ▁of ▁the ▁lowest ▁lum bar ▁verte br al ▁body ▁and ▁lum bar ization ▁of ▁the ▁upp erm ost ▁sac ral ▁segment . ▁It ▁involves ▁a ▁total ▁or ▁partial ▁un il ater al ▁or ▁bil ater al ▁fusion ▁of ▁the ▁trans verse ▁process ▁of ▁the ▁lowest ▁lum bar ▁verte bra ▁to ▁the ▁sac rum , ▁leading ▁to ▁the ▁formation ▁of ▁a ▁trans itional ▁ 5 th ▁lum bar ▁verte bra . ▁Of ▁importance ▁is ▁that ▁this ▁synd rome ▁will ▁result ▁in ▁a ▁pain ▁generating ▁ 4 th ▁lum bar ▁disc ▁resulting ▁in ▁a ▁" sci atic " ▁type ▁of ▁a ▁pain ▁correl ating ▁to ▁the ▁ 5 th ▁lum bar ▁n erve ▁root . ▁Usually ▁the ▁trans itional ▁verte bra ▁will ▁have ▁a ▁" sp at ulated " ▁trans verse ▁process ▁on ▁one ▁side ▁resulting ▁in ▁art ic ulation ▁or ▁partial ▁art ic ulation ▁with ▁the ▁sac rum ▁or ▁at ▁time ▁the ▁il ium ▁and ▁in ▁some ▁cases ▁with ▁both . ▁This ▁results ▁in ▁limited ▁/ ▁alter ed ▁motion ▁at ▁the ▁lum bo - s ac ral ▁art ic ulation