OBJECTIVE: Describe the clinical presentation, diagnostic evaluation, and 
successful treatment of a case of symptomatic unilateral lumbosacral junction 
pseudarticulation using a novel radiofrequency nerve ablation technique.
CASE: A 56-year-old female patient who had suffered with low back and right 
upper buttock pain for 16 years experienced incomplete relief with L4/5 facet 
joint radiofrequency ablation. She was found to have an elongated right L5 
transverse process that articulated with the sacral ala (Bertolotti's syndrome). 
Fluoroscopically guided local anesthetic/corticosteroid injection into the 
pseudarthrosis eliminated her residual right buttock pain for the duration of 
the local anesthetic only. Complete pain relief was achieved by injecting local 
anesthetic circumferentially around the posterior pseudarthrosis articular 
margin. Accordingly, bipolar radiofrequency strip thermal lesions were created 
at the same locations. Complete pain relief and full restoration of function was 
achieved for 16 months postprocedure.
CONCLUSION: This case report describes a novel radiofrequency technique for 
treating symptomatic lumbosacral junction pseudarticulation that warrants 
further evaluation.