\u201cYou can actually alter somebody\u2019s life functionality, because it\u2019s something that is easy to treat.\u201d — Dr. Hilary Onyiuke<\/cite><\/p>\n<\/blockquote>\n The authors of a paper published in the journal Neurochirurgie<\/em><\/a> came up with the Onyiuke Grading Scale, named for Dr. Hilary Onyiuke<\/a>, founder and co-director of UConn Health\u2019s Comprehensive Spine Program.<\/p>\n \u201cIt\u2019s a therapeutic kind of scale,\u201d Onyiuke says. \u201cYes, you make the diagnosis, you see what it is, but there was really no direction or guidance on how it could be treated.\u201d<\/p>\n Bertolotti syndrome is a congenital anomaly of the lower spinal structure that is not detectable with magnetic resonance imaging (MRI). Instead it takes traditional x-ray images of the lumbar spine to reveal.<\/p>\n Dr. Isaac Moss<\/a>, chair of UConn Health\u2019s Department of Orthopaedic Surgery, Dr. Ketan Bulsara<\/a>, chief of the Division of Neurosurgery, and Dr. David Choi<\/a>, UConn Health spinal oncology surgeon, are co-authors, along with two physicians who at the time of the research were fourth-year UConn medical students: Dr. Joshua Knopf, now a UConn surgery resident, and Dr. Subin Lee, who is doing a general surgery internship at Rush University in Chicago.<\/p>\n \u201cThis is a terrific contribution and a well-deserved honor for Dr. Onyiuke, and for UConn Health,\u201d Bulsara says. \u201cPhysicians around the world will use the Onyiuke Grading Scale to guide them as they find relief for their patients\u2019 chronic back pain. That speaks volumes about Dr. Onyiuke\u2019s surgical leadership, which spans both spinal and cranial neurosurgery. Through his thoughtful analysis he distilled a complex problem into a manageable grading scale that will provide generations of physicians guidance on how to treat this potentially debilitating syndrome.\u201d<\/p>\n Guidance on treatment for Bertolotti syndrome can go a long way in improving patient outcomes. It is one of many potential causes of back pain, and there often can be concurrent causes. Identifying Bertolotti syndrome as a cause and treating it nonsurgically could help reduce the need for eventual surgical interventions.<\/p>\n \u201cLet\u2019s say the patient had two spinal pathologies,\u201d Onyiuke says. \u201cOne is obvious, a routine one we see, we treat that, and they get better. And then, over time, the Bertolotti will kick up again. Bertolotti syndrome may not be the only problem the patient has, and it certainly can be a secondary problem. But if you don\u2019t treat it, or at least recognize it when you\u2019re treating the primary problem, then you\u2019re going to have a failure at some point.\u201d<\/p>\n The Onyiuke Grading Scale assigns one of four scores:<\/p>\n \u201cWith this grading, then, it\u2019s a question: Are you symptomatic, or are you not symptomatic,\u201d Onyiuke says. \u201cNo symptoms? Grade one, no treatment. But for who have back pain and leg pain, we developed an algorithm where we send them through conservative treatment such as physical therapy, like any other spinal pathology. If they do fine with it, then you don\u2019t need any treatment. If they don\u2019t improve, we\u2019re going to start diagnostic blocks.\u201d<\/p>\n While providing temporary relief, diagnostic nerve blocks also serve to pinpoint sources of pain by injecting anesthetic to specific nerves. Common methods include cortisone injections or radiofrequency treatments.<\/p>\n \u201cIf you do well with that, then you don\u2019t need anything else, you can just do that intermittently every few months,\u201d Onyiuke says. \u201cIf you don\u2019t, that\u2019s where the surgical component comes in. The surgical component could be a decompression, decompression and fusion, or fusion alone.\u201d<\/p>\n The researchers derived the Onyiuke Grading Scale from the study of Bertolotti syndrome patients at UConn Health in 2018 and 2019.<\/p>\n \u201cYou can actually alter somebody\u2019s life functionality, because it\u2019s something that is easy to treat,\u201d Onyiuke says. \u201cIt doesn\u2019t necessarily all have to lead to surgery, but in fact, the nonoperative treatment is critical because once you can manage them on that, they don\u2019t need surgery at all.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" UConn surgeons and medical students establish a grading scale, named for Dr. Hilary Onyiuke, to help physicians manage Bertolotti syndrome, a frequently underrecognized debilitating spine condition.<\/p>\n","protected":false},"author":111,"featured_media":174737,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_crdt_document":"","wds_primary_category":0,"wds_primary_series":0,"wds_primary_attribution":0,"footnotes":""},"categories":[2284,2231,2289,2287,2076,1868,179],"tags":[],"magazine-issues":[],"coauthors":[2010],"class_list":["post-174738","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-brain-spine-institute","category-health-well-being","category-neurosurgery","category-orthopedics","category-research","category-meds","category-uconn-health"],"pp_statuses_selecting_workflow":false,"pp_workflow_action":"current","pp_status_selection":"publish","acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-04-23 06:18:00","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/174738","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/users\/111"}],"replies":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/comments?post=174738"}],"version-history":[{"count":7,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/174738\/revisions"}],"predecessor-version":[{"id":174757,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/posts\/174738\/revisions\/174757"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media\/174737"}],"wp:attachment":[{"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/media?parent=174738"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/categories?post=174738"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/tags?post=174738"},{"taxonomy":"magazine-issue","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/magazine-issues?post=174738"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/today.uconn.edu\/wp-rest\/wp\/v2\/coauthors?post=174738"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"Dr.](\"https:\/\/today.uconn.edu\/wp-content\/uploads\/2021\/04\/Onyiuke-Hilary-20201216-TE-0009-crop-240x300.jpg\")
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