Currently Available Treatments for Bertolotti Syndrome / Lumbar Sacral Transitional Vertebrae (LSTV) Non-surgical options. • Lifestyle changes to relieve the affected parts of the spine, such as: B. repeated rotation and extension. • Over the counter (OTC) pain relievers. Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin or diclofenac. • Local anesthetics and, occasionally, corticosteroid injections under fluoroscopic guidance along the affected nerves or directly into the pseudoarthrosis to reduce inflammation. • Platelet rich plasma (PRP) Uses the body’s own blood platelets to reduce pain and inflammation and the healing of damaged joints from an injection with fluoroscopic guidance. (These treatments have not been well studied for Bertolotti syndrome.) • Radiofrequency ablation, a technique that uses heat to numb the affected nerves around a pseudo-joint. For the past 2 years, I have tried all of the above therapies with very little to no relief. Including: – Physiotherapy for 12 months. -Test of various prescription drugs. – Chiropractic adjustments. – stretching, swimming and yoga. – Corticosteroid injections into the L4-L5 intervertebral disc, facet joint, pseudo-joint and SI joint. – 3 x PRP injections into the right SI joint. – High frequency nerve ablation of the lower lumbar nerves. – Nerve stimulator study of the upper cluneal nerves. On Monday, under the care of my pain specialist, I will go to the hospital for a 7-day infusion of ketamine. In the coming months I will have a study on the spinal cord stimulator carried out as part of my pain treatment plan organized by my specialist.